Comparable viral decay with initial dolutegravir plus lamivudine versus dolutegravir-based triple therapy.
J Antimicrob Chemother
; 74(8): 2365-2369, 2019 08 01.
Article
em En
| MEDLINE
| ID: mdl-31039247
ABSTRACT
OBJECTIVES:
To expand understanding of the virological potency of initial dolutegravir plus lamivudine dual therapy (dolutegravir/lamivudine), we compared the viral decay seen in the pilot ACTG A5353 study with the decay observed with dolutegravir plus two NRTIs in the SPRING-1 and SINGLE studies, while also exploring the impact of baseline viral load (VL).METHODS:
Change in VL from baseline was calculated for timepoints shared by A5353 (nâ=â120, including 37 participants with pretreatment VL >100000 copies/mL), SPRING-1 (nâ=â51) and SINGLE (nâ=â417). The 95% CIs of change from baseline were determined for each observed week, using the mean log10-transformed VL, and compared between the dolutegravir/lamivudine and triple therapy groups using the Wilcoxon Rank Sum test for non-inferiority (δâ=â0.5). To assess the impact of baseline VL on viral decay, we examined a bi-exponential non-linear mixed-effect model.RESULTS:
The mean VL change from baseline to week 24 was -2.9 log10 copies/mL for dolutegravir/lamivudine versus -3.0 log10 copies/mL for dolutegravir-based three-drug therapy (Pâ<â0.001). In the decay model, baseline VL >100000 copies/mL was associated with a slower initial decay rate (d1). A faster initial decay rate was seen with dolutegravir/lamivudine, which was partially offset when baseline VL was >100000 copies/mL as indicated by a significant interaction between baseline VL and drug therapy group. The secondary decay rate (d2) was not significantly different from zero, with no significant associations.CONCLUSIONS:
Viral decay with dolutegravir/lamivudine was comparable to viral decay with dolutegravir-based triple therapy, even in individuals with higher pretreatment VL (>100000 copies/mL).
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
HIV-1
/
Lamivudina
/
Fármacos Anti-HIV
/
Carga Viral
/
Terapia Antirretroviral de Alta Atividade
/
Compostos Heterocíclicos com 3 Anéis
Limite:
Humans
Idioma:
En
Revista:
J Antimicrob Chemother
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Estados Unidos