Analysing the efficacy and tolerability of dolutegravir plus either rilpivirine or lamivudine in a multicentre cohort of virologically suppressed PLWHIV.
J Antimicrob Chemother
; 78(1): 117-121, 2022 12 23.
Article
in En
| MEDLINE
| ID: mdl-36272137
ABSTRACT
OBJECTIVES:
We aimed to investigate and compare the efficacy and safety of two dolutegravir-based two-drug regimens dolutegravirâ+âlamivudine versus dolutegravirâ+ârilpivirine.METHODS:
We analysed a cohort of people living with HIV (PLWHIV) switching to dolutegravirâ+âlamivudine or dolutegravirâ+ârilpivirine. We excluded from the analysis PLWHIV with no available pre-switch genotypic test or with a known resistance mutation to one of the study drugs. We evaluated incidence of virological failure (VF) and treatment discontinuation (TD), as well as changes in immunological and metabolic parameters.RESULTS:
We enrolled 592 PLWHIV 306 in the lamivudine group and 286 in the rilpivirine group. We observed nine VFs in the lamivudine group [1.4â VF per 100â patient-years of follow-up (PYFU)] and four VFs in the rilpivirine group (0.6â VF per 100â PYFU). Subsequent genotypic analysis showed no acquired resistance-associated mutations in those experiencing VF. Estimated probability of maintaining virological suppression at 144 and 240â weeks were 96.6% and 92.7%, respectively, in the lamivudine group and 98.7% and 98.7%, respectively, in the rilpivirine group (log-rank Pâ=â0.172). The estimated probability of maintaining study regimen at Week 240 was 82.3% in the lamivudine group and 85.9% in the rilpivirine group (log-rank Pâ=â0.018). We observed a significant improvement in CD4+ cell count at Week 240 in the lamivudine group (Pâ=â0.012); in the rilpivirine group we registered a significant increase in CD4/CD8 ratio (Pâ=â0.014).CONCLUSIONS:
Both analysed strategies are effective and safe as switch strategies in clinical practice, with a low incidence of VF and a favourable immunological recovery, even in the long term.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
HIV Infections
/
Anti-HIV Agents
Type of study:
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
J Antimicrob Chemother
Year:
2022
Document type:
Article
Affiliation country: