An evaluation of elvitegravir plus cobicistat plus tenofovir alafenamide plus emtricitabine as a single-tablet regimen for the treatment of HIV in children and adolescents

ABSTRACT

Introduction: Approximately 2.1 million of the estimated 36 million infected with HIV are children or adolescents. International guidelines for HIV-1 Infection suggest starting antiretrovirals (ARV) at the moment of diagnosis. Many factors limit the optimization of antiretroviral therapy in children and adolescents: lack of pediatric formulations, poor adherence, metabolic and pharmacokinetic changes associated withnormal child development and puberty.

Areas covered: Three integrase inhibitors are approved by the US Food and Drug Administration and by European Medical Agency for children and adolescents with HIV-1 infection. Raltegravir is approved for children aged 4 weeks to 18 years, while dolutegravir and elvitegravir co-formulated with cobicistat, emtricitabine, and tenofovir alafenamide (E/C/FTC/TAF) are approved for children from 6 years of age. This article evaluates E/C/FTC/TAF as a treatment option.

Expert opinion: E/C/FTC/TAF was well tolerated, and the antiretroviral activity and tolerability data of this combination support the use in children and adolescents. However, the studies regarding E/C/FTC/TAF in children and adolescents are scant. Consequently, additional studies investigating its safety and efficacy in children are paramount.

KEYWORDS:

• Elvitegravir
• cobicistat
• children
• adolescent
• antiretroviral therapy

Declaration of interest

G Rizzardini has received speaker’s fees from ViiV Healthcare, Gilead Sciences, Merck Sharp and Dohme, Janssen Pharmaceuticals and Angelini. They also have grant and/or research support from ViiV Healthcare, Gilead Sciences, Merck Sharp and Dohme and Janssen. A Capetti has received speaker’s fees from ViiV Healthcare, Gilead Sciences, Merck Sharp and Dohme and Janssen. Finally, GV Zuccotti and V Giacomet declare that they’ve received speaker’s fees from ViiV Healthcare, Gilead Sciences and Merck Sharp and Dohme. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript has not been funded.