Long-term outcome of lamivudine/dolutegravir dual therapy in HIV-infected, virologically suppressed patients

作者：Franco Maggiolo, Roberto Gulminetti, Layla Pagnucco, Margherita Digaetano, Adriana Cervo, Daniela Valenti, Annapaola Callegaro, Cristina Mussini · 发表于：BMC Infectious Diseases · 年份：2022 · DOI：10.1186/s12879-022-07769-6 · 被引用次数：16 · 研究领域：HIV/AIDS drug development and treatment、Hepatitis B Virus Studies、Hepatitis C virus research

BACKGROUND: The use of DTG-containing two-drug regimens is one of the most promising solutions to the need to ease the management of HIV treatment without harming its efficacy and safety. We report long- term results in patients switched, while virologically suppressed, to the combination of dolutegravir (DTG) plus lamivudine (3TC). METHODS: This is a prospective, clinical, uncontrolled cohort enrolling ART-experienced people living with HIV (PLWH) with HIV-RNA < 50 copies/ml for 6 months or longer, negative hepatitis B virus surface antigen, and without known M184V/I mutations. Kaplan-Meiers curves are used to describe persistency of virological suppression on therapy and a Cox regression model to evaluate baseline characteristics and the risk of stopping therapy. RESULTS: 218 individuals switched their regimen since 2015. The mean estimated follow-up was of 64.3 months (95% CI 61.3-67.3) for approximately 1000 patient/years. After 5 years of follow-up, 77.1% were still on the DTG-3TC combination. No virologic failure was detected throughout the whole study period, and only 15 subjects presented single isolated viral blips above 50 copies/ml. Most patients stopped therapy because of reasons unrelated to study drugs (lost to follow-up; patients' decision; moved to other Centers), but due to the unselected nature of the casuistry; 11 subjects died in the 5 years of follow-up mostly because of pre-existing co-morbidities (6 neoplastic diseases and 2 end-stage liver disease). Th...