Outcomes for persons with triple-class resistant HIV and a history of virologic failure.

Authors

Suzanne M Ingle, Fabrice Bonnet, Linda Wittkop, Alexandra Calmy, Ramon Teira, Peter F Rebeiro, Heidi M Crane, Christoph Stephan, Marc van der Valk, Christoph Boesecke, Giota Touloumi, M John Gill, Katharina Grabmeier-Pfistershammer, Federico Garcia, Francesca Ceccherini-Silberstein, Greer Burkholder, Adam Trickey, Jonathan A C Sterne, Mojgan Hessamfar, Antiretroviral Therapy Cohort Collaboration (ART-CC)

Published in

International journal of antimicrobial agents. Pages 107925. Jul 13, 2026. Epub Jul 13, 2026.

Abstract

To assess outcomes of heavily treatment experienced people with HIV (PWH) who received the antiretroviral therapy salvage regimen containing raltegravir, etravirine, and darunavir/ritonavir (known as TRIO).
Data were from the ART Cohort Collaboration; a collaboration of European and North American HIV cohort studies. Adult PWH were eligible if they had: history of virologic failure (VF) while receiving nonnucleoside reverse-transcriptase inhibitors (NNRTI); ≥3 primary protease inhibitor and nucleoside reverse transcriptase inhibitor mutations; ≤3 darunavir and NNRTI mutations; received TRIO between 2007-2018; VF at TRIO start; and not received any TRIO drugs previously. Follow-up began at TRIO start. We examined rates of: virologic suppression on TRIO, AIDS/death, receipt of drug-reducing regimens post-TRIO in those virologically suppressed, and subsequent virologic response. We used a competing risks framework to estimate 5-year cumulative incidence of outcomes.
Among 126 eligible PWH, 24% were female and median age was 46 years (Interquartile range[IQR]:41-50). Median follow-up was 7.9 years (IQR:5.1-9.3). 94(74.6%) were virologically suppressed on TRIO. Of these, 26(28%) subsequently switched to a drug-reducing regimen, of whom 19/26(73.1%) were virologically suppressed at their next VL measure. The 5-year cumulative incidence of outcomes was: stop TRIO and start another ≥3 drug regimen 39.1%; simplify 16.0%; stop TRIO without switch 8.8%; death on TRIO 7.2%.
Although the most common outcome after TRIO was switch to another ≥3 drug regimen, almost one third of virologically suppressed PWH under TRIO (with a history of multi-drug resistance) switched to a drug-reducing regimen, the majority of whom maintained suppression.

PMID:
42442619
Bibliographic data and abstract were imported from PubMed on 14 Jul 2026.

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