DOLAMA 200: Effectiveness and Safety of a Dual Therapy with Dolutegravir Plus Lamivudine in Treatment-Experienced HIV-1 Infected Real World Participants in Spain

Author:

Sequera-Arquelladas Sergio1ORCID,Hidalgo-Tenorio Carmen1,López-Cortés Luis2ORCID,Gutiérrez Alicia2,Santos Jesús3ORCID,Téllez Francisco4,Omar Mohamed5,Ferra-Murcia Sergio6ORCID,Fernández Elisa7,Javier Rosario1,García-Vallecillos Coral1,Pasquau Juan1

Affiliation:

1. Unit of Infectious Diseases, Virgen de las Nieves University Hospital, 18014 Granada, Spain

2. Department of Infectious Diseases, Virgen del Rocio University Hospitals, 41013 Seville, Spain

3. Unit of Infectious Diseases, Virgen de la Victoria University Hospital, 29010 Málaga, Spain

4. Unit of Infectious Diseases, Puerto Real Universitary Hospital, 11510 Cádiz, Spain

5. Unit of Infectious Diseases, Hospital Complex of Jaen, 23007 Jaén, Spain

6. Unit of Infectious Diseases, Hospital Torrecárdenas Hospital, 04009 Almería, Spain

7. Internal medicine Service, Hospital Poniente, 04700 Almería, Spain

Abstract

The continuous pharmacological advances in antiretroviral treatment (ART) and the increasing understanding of HIV drug resistance has led to a change in the paradigm of ART optimization in the setting of the viral suppression of treatment-experienced patients with the emerging evidence of the effectiveness and safety of dual therapies. The aim of this study is to determine the antiviral efficacy and safety of switching to Dolutegravir + Lamivudine in people living with HIV, and to analyze the rate of patients with virologic failure (VF). A total of 200 patients were included with a median age of 51 years, 189 cells/µL of nadir CD4+, 13 years on ART and four previous ART regimens. Among the 168 patients who completed a follow-up at 48 weeks, a total of five VFs occurred, resulting in a 2.98% (5/168) VF rate. The results of the intention-to-treat analysis were a VF rate of 2.54% (5/197), and the rate of patients/year with viral suppression was 98.3% (298/303) in the observed data analysis. We observed a significant improvement in mean CD4 lymphocytes, the CD4/CD8 ratio and lipid profiles. The optimization of ART to DTG plus 3TC is a cost-effective switch option for treatment-experienced HIV patients, and also improves their lipid profiles.

Funder

ViiV Healthcare

Publisher

MDPI AG

Subject

Virology,Infectious Diseases

Reference28 articles.

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3. Panel de Expertos de GeSIDA (2023). Documento de Consenso de GeSIDA/Plan Nacional Sobre el SIDA Respecto al Tratamiento Antirretroviral en Adultos Infectados por el Virus de la Inmunodeficiencia Humana, GeSIDA.

4. Panel on Antiretroviral Guidelines for Adults and Adolescents, Department of Health and Human Services (2023, July 30). Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV, Available online: https://clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-arv.

5. Simplification to dual therapy (atazanavir/ritonavir + lamivudine) versus standard triple therapy [atazanavir/ritonavir + two nucleos(t)ides] in virologically stable patients on antiretroviral therapy: 96 week results from an open-label, non-inferiority, randomized clinical trial (SALT study);Rubio;J. Antimicrob. Chemother.,2017

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