A characterization of the HIV population with limited/exhausted treatment options: a multicenter Belgian study

ABSTRACT

Objective

Describe the prevalence and characteristics of people living with HIV (PLWH) in Belgium with limited/exhausted treatment options.

Methods

A cross-sectional, multicenter study involving adult treatment-experienced individuals with limited/exhausted treatment options defined as having a multi-drug resistant HIV-1 or a history of multiple treatment changes. The primary outcome was to determine the prevalence of these individuals and classify them based on their two most recent consecutive HIV-1 viral loads (VLs): suppressed (2 VLs < 50 copies/mL), intermediate (≥1 VL between 50–200 copies/mL), or unsuppressed (2 VLs > 200 copies/mL). Secondary outcome was to characterize the participants included in this analysis.

Results

There were 119 individuals included (prevalence of 0.97%; 119 of 12 282 in care). The majority were aged > 50 years (88.2%), women represented 35.3%, and individuals were primarily White (54.7%). Median (IQR) CD4⁺ T-cell count was 635 (400–875) cells/µL and most (42%) were on a 3-drug ART regimen. Overall, 87.4% were classified as suppressed, 9.2% as intermediate, and 3.4% as unsuppressed. On multivariable analysis, CD4⁺ T-cell count < 200 cells/µL was associated with being classified as intermediate or unsuppressed (p = 0.004).

Conclusion

In this analysis of PLWH in Belgium, individuals with limited/exhausted treatment options represented a small fraction. Most were on a 3-drug ART regimen, were virologically suppressed, and had a CD4⁺ T-cell count within normal range. A small proportion were not virologically suppressed while others, despite being suppressed, were on ≥ 4-drug ART regimens. As such, new therapeutic options are needed to achieve and maintain virologic suppression in such individuals while decreasing their pill burden.

KEYWORDS:

• HIV
• multi-drug resistant HIV-1
• extensive treatment history
• limited/exhausted treatment options
• Belgium

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, RN, upon reasonable request.

Additional information

Funding

This study was supported by ViiV Healthcare.