Higher Mortality Rates Associated with Raltegravir Use in HIV Patients

Strategic Insights -

A new study conducted by researchers from the University of Copenhagen and the Centre of Excellence for Health, Immunity Infections (CHIP) has found an association between the use of raltegravir, an integrase strand-transfer inhibitor (INSTI), and higher mortality rates in HIV patients. The study, published in eClinicalMedicine, analyzed data from a large cohort of approximately 40,000 adults with HIV in Europe and Australia, and found that those who started raltegravir had a higher mortality rate compared to those who started other INSTIs. However, the study also found that the association was confounded by indication and channelling bias.

Key Takeaways:

  • The study found a higher mortality rate among participants who started raltegravir compared to those who started other INSTIs, with a crude mortality rate of 12.9 per 1000 person-years of follow-up (PYFU) for raltegravir users, compared to 9.1 per 1000 PYFU for non-raltegravir users.
  • The association between raltegravir use and mortality was significantly reduced after accounting for confounding variables using inverse probability of treatment weights (IPTW) and adjustment for age.
  • The study found that raltegravir use was associated with higher viral load, hepatitis C positive status, end-stage renal disease, chemotherapy near baseline, and cardiovascular disease.
  • The study's findings suggest that prior reports of an association between raltegravir use and mortality may have been confounded by indication and channelling bias.
  • The study was conducted by researchers from the University of Copenhagen and the Centre of Excellence for Health, Immunity Infections (CHIP), in collaboration with several other research institutions and pharmaceutical companies.
  • The study included data from approximately 40,000 adults with HIV in Europe and Australia.

Sources:

  • Mortality using raltegravir versus other integrase strand-transfer inhibitors in people with HIV in Europe and Australia: a prospective multicentre study. eClinicalMedicine, 2025;89:103521.
  • NewsRx. Researchers from University of Copenhagen Provide Details of New Studies and Findings in the Area of HIV/AIDS (Mortality using raltegravir versus other integrase strand-transfer inhibitors in people with HIV in Europe and Australia: a ...). AIDS Weekly. October 20, 2025; p 205.
  • Lene Ryom, CHIP, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • Erich Tusch, Christian Hoffmann, Olaf Degen, Robert Zangerle, Huldrych F. Gunthard, Ferdinand Wit, Cristina Mussini, Antonella Castagna, Charlotte Martin, Andrea Giacomelli, Jorg Janne Vehreschild, Josip Begovac, Vani Vannappagari, Jim Rooney.