The role of rilpivirine in Southern Africa

Southern African Journal of HIV Medicine

 
 
Field Value
 
Title The role of rilpivirine in Southern Africa
 
Creator Moorhouse, Michelle A. Cohen, Karen
 
Subject — HIV; Rilpivirine; Antiretrovirals; Non-nucleoside reverse transcriptase inhibitor; Southern Africa
Description Rilpivirine, a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI), is included as an option in first-line antiretroviral therapy (ART) for antiretroviral-naïve individuals in treatment guidelines in high-income countries, including the United States and many European countries. Rilpivirine is available in a single-tablet fixed-dose combination, has a favourable tolerability profile and is of relatively low cost. However, rilpivirine has reduced efficacy in patients commencing ART at high viral loads. Therefore, baseline viral load testing is required before commencing rilpivirine, and it is not recommended for patients commencing therapy with a viral load greater than 100 000 copies/mL. Rilpivirine is not included in the treatment regimens recommended by the World Health Organization (WHO), which form the basis of treatment guidelines in many lower- and middle-income countries. Some patients commencing standard first-line regimens experience treatment-limiting toxicity. A low-cost rilpivirine-containing fixed-dose combination would potentially be a useful addition to treatment options available in South Africa and other countries in the region, for patients who do not tolerate standard first-line ART. In this article, we explore the utility of rilpivirine as an option in ART in South Africa and the region in the context of current public-sector regimens. We consider what role rilpivirine might play if first-line therapy moves to a dolutegravir-based regimen, as has already happened in some lower- and middle-income countries, including Botswana, Kenya and Brazil. Finally, we describe emerging evidence for rilpivirine in the prevention of HIV transmission.
 
Publisher AOSIS
 
Contributor
Date 2019-05-29
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/epub+zip application/xml application/pdf
Identifier 10.4102/sajhivmed.v20i1.825
 
Source Southern African Journal of HIV Medicine; Vol 20, No 1 (2019); 7 pages 2078-6751 1608-9693
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://sajhivmed.org.za/index.php/hivmed/article/view/825/1430 https://sajhivmed.org.za/index.php/hivmed/article/view/825/1429 https://sajhivmed.org.za/index.php/hivmed/article/view/825/1431 https://sajhivmed.org.za/index.php/hivmed/article/view/825/1422
 
Coverage — — —
Rights Copyright (c) 2019 Michelle A. Moorhouse, Karen Cohen https://creativecommons.org/licenses/by/4.0
ADVERTISEMENT