OBJECTIVES: We reviewed the 24 week outcomes of HIV-infected patients from our hospital who had their ART switched to dolutegravir monotherapy on an individual clinical basis. METHODS: Retrospective hospital database assessment of virally suppressed patients in whom the treating physician had switched to 50 mg of dolutegravir once daily due to one or more of the following reasons: antiretroviral-related adverse effects; comorbidities; risk of interactions; or archived resistance. Patients had ≥24 weeks of follow-up. Population, virological and immunological responses and safety and tolerability are described. RESULTS: Thirty-three (22 on PIs, of whom 18 had ritonavir-boosted PI monotherapy) patients were identified: median (IQR) age of 56 (50-62) years, 55% women, median (IQR) of 19 (17-23) years of known HIV infection, 39% prior AIDS events, median (IQR) of 8 (4-13) years with undetectable plasma HIV-1 RNA and median (IQR) CD4 cell count of 596 (420-843) cells/mm(3). Twenty-five (76%) patients had antiretroviral-related adverse effects, 32 (97%) patients had comorbidities, 28 (85%) patients had risk of interactions and 16 (48%) patients had archived resistance. One patient with suboptimal adherence had low-level virological failure through weeks 4-24. HIV RNA genotypic resistance tests detected no integrase mutations at weeks 4 and 24, but 118R was detected in 7% of the integrated HIV DNA at 24 weeks. Patients had significant median decreases in triglycerides (-117 mg/dL), total cholesterol (-36 mg/dL), the total cholesterol/HDL cholesterol ratio (-0.7) and high-sensitivity C-reactive protein (-0.05 mg/dL) (P ≤ 0.007), although the Chronic Kidney Disease Epidemiology Collaboration equation also decreased (-7.1 mL/min) (P < 0.0001). CONCLUSIONS: These data suggest the efficacy of dolutegravir monotherapy as a maintenance strategy to be further confirmed in randomized clinical trials.
OBJECTIVES: We reviewed the 24 week outcomes of HIV-infectedpatients from our hospital who had their ART switched to dolutegravir monotherapy on an individual clinical basis. METHODS: Retrospective hospital database assessment of virally suppressed patients in whom the treating physician had switched to 50 mg of dolutegravir once daily due to one or more of the following reasons: antiretroviral-related adverse effects; comorbidities; risk of interactions; or archived resistance. Patients had ≥24 weeks of follow-up. Population, virological and immunological responses and safety and tolerability are described. RESULTS: Thirty-three (22 on PIs, of whom 18 had ritonavir-boosted PI monotherapy) patients were identified: median (IQR) age of 56 (50-62) years, 55% women, median (IQR) of 19 (17-23) years of known HIV infection, 39% prior AIDS events, median (IQR) of 8 (4-13) years with undetectable plasma HIV-1 RNA and median (IQR) CD4 cell count of 596 (420-843) cells/mm(3). Twenty-five (76%) patients had antiretroviral-related adverse effects, 32 (97%) patients had comorbidities, 28 (85%) patients had risk of interactions and 16 (48%) patients had archived resistance. One patient with suboptimal adherence had low-level virological failure through weeks 4-24. HIV RNA genotypic resistance tests detected no integrase mutations at weeks 4 and 24, but 118R was detected in 7% of the integrated HIV DNA at 24 weeks. Patients had significant median decreases in triglycerides (-117 mg/dL), total cholesterol (-36 mg/dL), the total cholesterol/HDL cholesterol ratio (-0.7) and high-sensitivity C-reactive protein (-0.05 mg/dL) (P ≤ 0.007), although the Chronic Kidney Disease Epidemiology Collaboration equation also decreased (-7.1 mL/min) (P < 0.0001). CONCLUSIONS: These data suggest the efficacy of dolutegravir monotherapy as a maintenance strategy to be further confirmed in randomized clinical trials.
Authors: Alonso Heredia; Said Hassounah; Sandra Medina-Moreno; Juan C Zapata; Nhut M Le; Yingshan Han; James S Foulke; Charles Davis; Joseph Bryant; Robert R Redfield; Mark A Wainberg Journal: J Antimicrob Chemother Date: 2017-09-01 Impact factor: 5.790
Authors: Hanh T Pham; Lydia Labrie; Ingeborg E A Wijting; Said Hassounah; Ka Yee Lok; Inna Portna; Mark E Goring; Yingshan Han; Cynthia Lungu; Marchina E van der Ende; Bluma G Brenner; Charles A Boucher; Bart J A Rijnders; Jeroen J A van Kampen; Thibault Mesplède; Mark A Wainberg Journal: J Infect Dis Date: 2018-07-24 Impact factor: 5.226
Authors: Koen K A Van Rompay; Said Hassounah; Brandon F Keele; Jeffrey D Lifson; Amir Ardeshir; Jennifer Watanabe; Hanh Thi Pham; Elena Chertova; Raymond Sowder; Jan Balzarini; Thibault Mesplède; Mark A Wainberg Journal: J Virol Date: 2019-01-04 Impact factor: 5.103
Authors: Ameya R Kirtane; Omar Abouzid; Daniel Minahan; Taylor Bensel; Alison L Hill; Christian Selinger; Anna Bershteyn; Morgan Craig; Shirley S Mo; Hormoz Mazdiyasni; Cody Cleveland; Jaimie Rogner; Young-Ah Lucy Lee; Lucas Booth; Farhad Javid; Sarah J Wu; Tyler Grant; Andrew M Bellinger; Boris Nikolic; Alison Hayward; Lowell Wood; Philip A Eckhoff; Martin A Nowak; Robert Langer; Giovanni Traverso Journal: Nat Commun Date: 2018-01-09 Impact factor: 14.919