Arturo Ciccullo1, Gianmaria Baldin1, Amedeo Capetti2, Stefano Rusconi3, Gaetana Sterrantino4, Gabriella d'Ettorre5, Manuela Colafigli6, Sara Modica7, Filippo Lagi4, Andrea Giacomelli3, Maria Vittoria Cossu2, Sibilla Restelli2, Andrea De Luca7, Simona Di Giambenedetto1. 1. Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. 2. Division of Infectious Diseases, Department of Infectious Diseases, Luigi Sacco University Hospital, Milan, Italy. 3. Infectious Diseases Unit, DIBIC Luigi Sacco, University of Milan, Milan, Italy. 4. Division of Tropical and Infectious Diseases, 'Careggi' Hospital, Florence, Italy. 5. Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy. 6. Infectious Dermatology and Allergology Unit, IFO S. Gallicano Institute (IRCCS), Rome, Italy. 7. Infectious Diseases Unit, Siena University Hospital, Siena, Italy.
Abstract
BACKGROUND: Two-drug regimens are increasingly used in clinical practice as switch strategies. We compared the efficacy and safety of two dolutegravir (DTG)-based dual therapies: DTG plus lamivudine (3TC group) versus DTG plus rilpivirine (RPV group). METHODS: In a multicentre cohort of virologically suppressed (HIV RNA <50 copies/ml) HIV+ patients switching to DTG+3TC or DTG+RPV we analysed the incidence of virological failures (VF) and treatment discontinuations (TD), as well as their predictors. RESULTS: We analysed 416 patients, 229 in the 3TC group and 187 in the RPV group. The 3TC group, during 344.4 person-years of follow-up (PYFU), had 10 VF without the emergence of resistance mutations, while 30 patients discontinued the regimen. In the RPV group, during 371.0 PYFU, there were 5 VF (1 developed non-nucleoside reverse transcriptase inhibitor mutations Y181C and E138Q) and 13 TD. The estimated probability of remaining free from VF at 48 weeks showed no significant difference between groups (log-rank 0.172). We found a higher risk of VF in patients with peak viral load >500,000 copies/ml in both treatment groups (log-rank P=0.004 in each group). The estimated probability of remaining in the study regimen at week 48 was 89.0% with DTG+3TC and 96.1% with DTG+RPV (log-rank 0.015). After adjusting for potential confounders, treatment group was not associated with TD. A significant decrease in total cholesterol was observed at week 48 in both groups while renal function remained unchanged. CONCLUSIONS: DTG+RPV and DTG+3TC were compared in populations with different characteristics in clinical practice: both regimens showed good effectiveness and improved lipid profile.
BACKGROUND: Two-drug regimens are increasingly used in clinical practice as switch strategies. We compared the efficacy and safety of two dolutegravir (DTG)-based dual therapies: DTG plus lamivudine (3TC group) versus DTG plus rilpivirine (RPV group). METHODS: In a multicentre cohort of virologically suppressed (HIV RNA <50 copies/ml) HIV+ patients switching to DTG+3TC or DTG+RPV we analysed the incidence of virological failures (VF) and treatment discontinuations (TD), as well as their predictors. RESULTS: We analysed 416 patients, 229 in the 3TC group and 187 in the RPV group. The 3TC group, during 344.4 person-years of follow-up (PYFU), had 10 VF without the emergence of resistance mutations, while 30 patients discontinued the regimen. In the RPV group, during 371.0 PYFU, there were 5 VF (1 developed non-nucleoside reverse transcriptase inhibitor mutations Y181C and E138Q) and 13 TD. The estimated probability of remaining free from VF at 48 weeks showed no significant difference between groups (log-rank 0.172). We found a higher risk of VF in patients with peak viral load >500,000 copies/ml in both treatment groups (log-rank P=0.004 in each group). The estimated probability of remaining in the study regimen at week 48 was 89.0% with DTG+3TC and 96.1% with DTG+RPV (log-rank 0.015). After adjusting for potential confounders, treatment group was not associated with TD. A significant decrease in total cholesterol was observed at week 48 in both groups while renal function remained unchanged. CONCLUSIONS:DTG+RPV and DTG+3TC were compared in populations with different characteristics in clinical practice: both regimens showed good effectiveness and improved lipid profile.
Authors: Neha Sheth Pandit; Daniel B Chastain; Andrea M Pallotta; Melissa E Badowski; Emily C Huesgen; Sarah M Michienzi Journal: Curr Infect Dis Rep Date: 2019-09-07 Impact factor: 3.725
Authors: Y S Punekar; D Parks; M Joshi; S Kaur; L Evitt; V Chounta; M Radford; D Jha; S Ferrante; S Sharma; J Van Wyk; A de Ruiter Journal: HIV Med Date: 2021-02-02 Impact factor: 3.180