{ "abstract": "Background Bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) is one of the most used and well-tolerated regimens. Nevertheless, a minority of people with HIV (PWH) discontinued treatment. We aimed to investigate the reasons for B/F/TAF discontinuation and the regimens to which PWH were subsequently switched.Methods Consecutive PWH enrolled in the SCOLTA project switching to or initiating their first antiretroviral treatment (ART) with B/F/TAF were included. PWH were followed up until treatment discontinuation and information about the following regimen was collected if possible.Results Of 1180 enrolled PWH, 1004 had at least one follow-up visit and entered the analysis. Mean age was 48.0 years (standard deviation 12.6), 75.9% were male, and 27.9% were naïve (N) to antiretrovirals at T0 ( table 1). The median observation time was 28 months (interquartile range 14-42). During the follow-up, 211 PWH (21%) discontinued the treatment.The most frequent causes of B/F/TAF discontinuation were: simplification to dual therapy in 47 (22.3%) PWH, switch to long-acting treatment in 29 (13.7%), adverse events in 28 (13.2%), switch to other regimes due to drug-drug interactions in 17 (8.8%), death in 9 (4.3%), treatment failure in 6 (2.8%), patient’s preference in 2 (0.9%) and pregnancy in 2 (0.9%). Other reasons were listed in 14 PWH (6.6%, 9 changes of referring center and 5 enrollments to a trial) and 57 (27.0%) PWH were lost to follow-up (table 2).Eighty (37.0%) had no known subsequent regimen (9 PWH died, 14 changed center or started a trial, 57 were lost to follow-up). Of the 131 remaining, we had information on the following treatment in 102 (76.7%), of which 1 was suspended for 9 months. Fifty-six (55%) PWH switched to another INSTI-based regimen, while 29 (28%) to a long-acting treatment.Conclusions In our cohort, B/F/TAF confirmed its durability and safety with very few adverse events or treatment failures. In real-world practice, discontinuation of B/F/TAF was unrelated to toxicity or failure. Instead, it reflected proactive strategies, including switches to long-acting therapy or simplification to dual regimens driven by clinical decision-making.Abstract SC35 Table 1Characteristics of 1004 people with HIV (PWH) according to treatment status at last visitAbstract SC35 Table 2Post-discontinuation regimens and csuses of discontinustion", "authors": [ { "affiliations": [ "Infectious Diseases Unit, IRCCS San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy" ], "name": "V Cogliandro" }, { "affiliations": [ "Infectious Diseases Unit, IRCCS San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy" ], "name": "N Squillace" }, { "affiliations": [ "Fondazione ASIA Onlus, Buccinasco (MI), Italy" ], "name": "E Ricci" }, { "affiliations": [ "Infectious Diseases Unit, Università degli Studi di Enna Kore, Italy" ], "name": "P Maggi" }, { "affiliations": [ "Infectious Diseases Unit, Ospedale Policlinico San Martino – IRCCS per l’Oncologia", "Department of Health’s Sciences, University of Genoa, Genoa, Italy" ], "name": "L Taramasso" }, { "affiliations": [ "Unit of Infectious Diseases, ASST della Valle Olona – Busto Arsizio (VA), Italy" ], "name": "B Menzaghi" }, { "affiliations": [ "Infectious Diseases Unit, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy" ], "name": "E Sarchi" }, { "affiliations": [ "Unit of Infectious Diseases, Santa Maria Hospital, Perugia, Italy" ], "name": "GV De Socio" }, { "affiliations": [ "Unit of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy" ], "name": "S Piconi" }, { "affiliations": [ "Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, AOU Policlinico G. Martino, Messina, Italy" ], "name": "GF Pellicanò" }, { "affiliations": [ "Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy" ], "name": "T Bini" }, { "affiliations": [ "Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, Italy" ], "name": "G Madeddu" }, { "affiliations": [ "Infectious Disease Unit, University Hospital Luigi Vanvitelli, Naples, Italy" ], "name": "S Martini" }, { "affiliations": [ "Department of Infectious Diseases, Galliera Hospital, Genoa, Italy" ], "name": "E Pontali" }, { "affiliations": [ "Infectious Diseases Department, Sanremo Hospital, Sanremo, Italy" ], "name": "G Cenderello" }, { "affiliations": [ "Infectious Disease Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy" ], "name": "A Bandera" }, { "affiliations": [ "Unit of Infectious Diseases, Garibaldi Hospital, Catania, Italy" ], "name": "BM Celesia" }, { "affiliations": [ "Division I of Infectious and Tropical Diseases, ASL Città di Torino, Italy" ], "name": "G Orofino" }, { "affiliations": [ "Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy" ], "name": "S Ferrara" }, { "affiliations": [ "Infectious Diseases and Gender Medicine Unit, Cotugno Hospital, AO dei Colli, Naples, Italy" ], "name": "MA Carleo" }, { "affiliations": [ "Unit of Infectious Diseases, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy" ], "name": "A Cascio" }, { "affiliations": [ "Infectious Diseases Unit, Ospedale Policlinico San Martino – IRCCS per l’Oncologia", "Department of Health’s Sciences, University of Genoa, Genoa, Italy" ], "name": "A Di Biagio" }, { "affiliations": [ "Infectious Diseases Unit, IRCCS San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy" ], "name": "P Bonfanti" }, { "affiliations": [ "Infectious Diseases Unit, IRCCS San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy", "Fondazione ASIA Onlus, Buccinasco (MI), Italy", "Infectious Diseases Unit, Università degli Studi di Enna Kore, Italy", "Infectious Diseases Unit, Ospedale Policlinico San Martino – IRCCS per l’Oncologia", "Department of Health’s Sciences, University of Genoa, Genoa, Italy", "Unit of Infectious Diseases, ASST della Valle Olona – Busto Arsizio (VA), Italy", "Infectious Diseases Unit, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy", "Unit of Infectious Diseases, Santa Maria Hospital, Perugia, Italy", "Unit of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy", "Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, AOU Policlinico G. Martino, Messina, Italy", "Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy", "Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, Italy", "Infectious Disease Unit, University Hospital Luigi Vanvitelli, Naples, Italy", "Department of Infectious Diseases, Galliera Hospital, Genoa, Italy", "Infectious Diseases Department, Sanremo Hospital, Sanremo, Italy", "Infectious Disease Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy", "Unit of Infectious Diseases, Garibaldi Hospital, Catania, Italy", "Division I of Infectious and Tropical Diseases, ASL Città di Torino, Italy", "Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy", "Infectious Diseases and Gender Medicine Unit, Cotugno Hospital, AO dei Colli, Naples, Italy", "Unit of Infectious Diseases, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy" ], "name": "for the CISAI Study Group" } ], "title": "SC35 Drivers of B/F/TAF discontinuation: reflecting strategy rather than failure or toxicity", "uid": "72e687ca-7683-5506-86c4-f75aa000f893" }