Dolutegravir-based monotherapy or dual therapy maintains a high proportion of viral suppression even in highly experienced HIV-1-infected patients

March 27, 2016 at 3:25 pm

Journal of Antimicrobial Chemotherapy April 2016 V.71 N.4 P.1046-1050

Camelia Gubavu, Thierry Prazuck, Mohamadou Niang, Jennifer Buret, Catherine Mille, Jérôme Guinard, Véronique Avettand-Fènoël, and Laurent Hocqueloux

1Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional, Orléans, France

2Laboratoire de Virologie, Centre Hospitalier Régional, Orléans, France

3Laboratoire de Virologie, Hôpital Necker-Enfants Malades, APHP, Paris, France

4Université Paris-Descartes Sorbonne Paris Cité, Faculté de Médecine, EA 7327, Paris, France

Background

Dolutegravir is a powerful, well-tolerated integrase inhibitor with a high genetic barrier to resistance and may thus constitute the backbone of lightened regimens.

Methods

This was a monocentric, retrospective study. HIV-1-infected patients receiving dolutegravir as monotherapy (mDGV) or dual therapy (dDGV) were systematically identified. The primary outcome was the proportion of patients who maintained undetectable (<50 copies/mL) plasma HIV RNA [plasma viral load (PVL)].

Results

We identified 21 patients on mDGV (50 mg/day) and 31 on dDGV (50 or 100 mg/day, with atazanavir±ritonavir, n=12; rilpivirine, n=11; maraviroc, n=3; lamivudine, n=3; darunavir/ritonavir, n=1; or abacavir, n=1). All of the patients were treatment experienced and 48% had experienced at least one virological failure. The baseline characteristics were as follows (for the mDGV/dDGV patients, respectively): 5%/29% had a history of AIDS; the median (IQR) highest PVL was 4.5 (4.3–5.5)/5.3 (4.7–5.6) log copies/mL; the median (IQR) nadir CD4+ count was 310 (280–468)/199 (134–281) cells/mm3; 100% had undetectable PVL before the mDGV for a median (IQR) duration of 5.9 (3.5–9.9) years/81% had undetectable PVL before the dDGV for a median (IQR) duration of 3.7 (1.4–8.3) years; and the median (IQR) HIV DNA level was 2.7 (2.1–3.1)/2.9 (2.7–3) log copies/106 PBMCs. At the last follow-up visit, 100% and 97% of patients showed undetectable PVL following mDGV and dDGV, respectively [median (IQR) follow-up of 32 (29–45) and 50 (30–74) weeks, respectively].

Conclusions

In our experience, dolutegravir-based lightened regimens provided a high proportion of viral suppression, even in highly treatment-experienced patients.

PDF

http://jac.oxfordjournals.org/content/71/4/1046.full.pdf

 

Entry filed under: Antirretrovirales, Biología Molecular, HIV/SIDA, HIV/SIDA HAART, HIV/SIDA Laboratorio, Infecciones virales. Tags: .

Any impact of blips and low-level viraemia episodes among HIV-infected patients with sustained virological suppression on ART? Mejora del diagnóstico de las infecciones por Chamydia trachomatis en la era molecular, una oportunidad para los sistemas de vigilancia


Calendar

March 2016
M T W T F S S
« Feb   Apr »
 123456
78910111213
14151617181920
21222324252627
28293031  

Most Recent Posts


%d bloggers like this: