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Five Years With Dolutegravir Plus Lamivudine as a Switch Strategy: Much More Than a Positive Finding

2021; Lippincott Williams & Wilkins; Volume: 88; Issue: 3 Linguagem: Inglês

10.1097/qai.0000000000002787

1944-7884

Arturo Ciccullo, Vanni Borghi, Andrea Giacomelli, Maria Vittoria Cossu, Gaetana Sterrantino, Alessandra Latini, Maria Carla Re, Andrea De Vito, William Gennari, Giordano Madeddu, Amedeo Capetti, Gabriella d’Ettorre, Cristina Mussini, Stefano Rusconi, Simona Di Giambenedetto, Gianmaria Baldin,

HIV/AIDS Research and Interventions

Results from clinical trials and observational studies suggest that dolutegravir plus lamivudine could be an effective and well-tolerated option for simplification in HIV-1-positive patients. We aimed to assess long-time efficacy and safety in our multicenter cohort.This was a retrospective study enrolling HIV-1-infected, virologically suppressed patients switching to dolutegravir + lamivudine. We performed survival analysis to evaluate time to virological failure (VF, defined by a single HIV-RNA ≥1000 copies/mL or by 2 consecutive HIV-RNA ≥ 50 copies/mL) and treatment discontinuation (defined as the interruption of either 3TC or dolutegravir), assessing predictors via Cox regression analyses.Seven-hundred eighty-five patients were considered for the analysis: 554 were men (70.6%), with a median age of 52 years (interquartile range 45-58 years). Estimated probabilities of maintaining virological suppression at weeks 96, 144, and 240 were 97.7% (SD ±0.6), 96.9% (SD ±0.8), and 96.4% (SD ±0.9), respectively. A non-B HIV subtype (P = 0.014) and a previous VF (P = 0.037) resulted predictors of VF. We did not observe differences in probability of VF in people living with HIV with an M184V resistance mutation (P = 0.689); however, in a deeper analysis, M184V mutation was a predictor of VF (P = 0.038) in patients with time of virological suppression <88 months. Estimated probabilities of remaining on study regimen at 96, 144, and 240 weeks were 82.9% (SD ±1.4), 79.7% (SD ±1.6) and 74.3% (SD ±2.2), respectively.Our findings show the long-term efficacy and tolerability of dolutegravir plus lamivudine in virologically suppressed patients.