Treatment Responses to Integrase Strand-transfer Inhibitor-containing Antiretroviral Regimens in Combination With Short-course Rifapentine-based Regimens for Latent Tuberculosis Infection Among People With HIV
Kuan‐Yin Lin, Hsin‐Yun Sun, Chia‐Jui Yang, Po‐Liang Lu, Yuan‐Ti Lee, Nan–Yao Lee, Bo‐Huang Liou, Hung-Jen Tang, Mei‐Hui Lee, Ning‐Chi Wang, Tun‐Chieh Chen, Ing-Moi Hii, Sung‐Hsi Huang, Chi‐Ying Lin, Chin-Shiang Tsai, Chien‐Yu Cheng, Chien-Ching Hung, the Taiwan HIV Study Group, Chien-Ching Hung, Sui‐Yuan Chang, Hsin-Yun Sun, Yu‐Shan Huang, Kuan‐Yin Lin, Guan‐Jhou Chen, Pei‐Ying Wu, Ling-Ya Chen, Hsi‐Yen Chang, Wen‐Chun Liu, Yi‐Ching Su, Ning‐Chi Wang, Te‐Yu Lin, Chia‐Jui Yang, Mao‐Song Tsai, Mei‐Hui Lee, Yi‐Chieh Lee, Shu‐Hsing Cheng, Chien-Yu Cheng, Bo‐Huang Liou, Sung‐Hsi Huang, Yi‐Chia Huang, An-Ting Peng, Yuan‐Ti Lee, Yu-Lin Lee, Chia‐Chun Lin, Shih‐Ping Lin, Chia-Yin Hsieh, Hsiu‐Wen Wang, Mao‐Wang Ho, Chun-Eng Liu, Ing-Moi Hii, Chi‐Ying Lin, Hung-Jen Tang, Nan–Yao Lee, Chin-Shiang Tsai, Tung-Che Hung, Yen‐Hsu Chen, Po‐Liang Lu, Chun-Yuan Lee, Tun‐Chieh Chen, Hung‐Chin Tsai, Hsi-Hsun Lin, Chen‐Hsiang Lee
Abstract
BACKGROUND: Real-world experience with combinations of short-course rifapentine-based regimens and integrase strand-transfer inhibitor-containing antiretroviral therapy (ART) in management of latent tuberculous infection (LTBI) is limited among people with human immunodeficiency virus (PWH). METHODS: From August 2019 to October 2022, PWH receiving 3 months of weekly rifapentine plus isoniazid (3HP) or 1 month of daily rifapentine plus isoniazid (1HP) in combination with ART were included. The primary outcome was virologic response within 12 months after LTBI treatment; secondary outcomes included treatment completion rate and safety of LTBI regimens. RESULTS: During the study period, 479 PWH (94.6% male; median age, 43 years) were included: 142 received 1HP and bictegravir (BIC)-containing regimens (1HP/BIC group), 46 1HP and dolutegravir (DTG)-containing regimens (1HP/DTG group), 38 3HP and BIC-containing regimens (3HP/BIC group), 214 3HP and DTG-containing regimens (3HP/DTG group), 17 1HP and other ART regimens (1HP/others group), and 22 3HP/other ART regimens (3HP/others group). In the intention-to-treat analysis, the proportions of PWH maintaining plasma HIV-1 RNA <200 copies/mL within 12 months after LTBI treatment completion were 96.5% (1HP/BIC), 100% (1HP/DTG), 100% (3HP/BIC), 95.8% (3HP/DTG), 100% (1HP/others), and 100% (3HP/others). The overall completion rates were >80% for all treatment groups, whereas >50% of the included PWH experienced any adverse event. LTBI regimens and ART combinations were not associated with virologic response and completion rate. CONCLUSIONS: Combinations of short-course rifapentine-based regimens and integrase strand-transfer inhibitor-containing ART maintained viral suppression for most PWH within 12 months of LTBI treatment completion with low rates of grade 3 or higher adverse events.