Clinical data and practical experience related to Stribild as an option in patients with HIV infection

Single tablet combination of tenofovir disoproxil fumarate, emtricitabine, elvitegravir and cobicistat [TDF/FTC/EVG/COBI] has been licensed for the use in HIV infected individuals as Stribild®. In treatment naïve subjects high virological efficacy of the regimen was proved. Recently use of this combination has been investigated as the switch option for the virologically suppressed individuals without drug resistance to the components of the compound. In twin studies – STRATEGY-NNRTI and STRATEGY-PI non-inferiority of the switch to TDF/FTC/EVG/COBI was confirmed, discontinuations due to adverse events were infrequent and no emergence of integrase drug resistance was observed. Simplification of the treatment using Stribild is an attractive, effective, safe and well tolerated option which also allows for the optimization of adherence. Elvitegravir-based therapies may be used to replace other antiretroviral regimens in virologically suppressed cases, with no compromise to the virological efficacy of the combination. Use of this novel integrase inhibitor seems to provide durable option for the long-term treatment. In this review we also present a case of the successful treatment optimization with TDF/FTC/EVG/COBI in a patient with poor adherence and protease resistance.