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

• DOI: 10.1186/s12879-022-07769-6
• Publication Date: 2022-10-12T12:05:50Z
• Authors: Franco Maggiolo; Roberto Gulminetti; Layla Pagnucco; Margherita Digaetano; Adriana Cervo; Daniela Valenti; Annapaola Callegaro; Cristina Mussini
• Keywords: Dolutegravir; Regimen

Abstract Background The use of DTG-containing two-drug regimens is one the most promising solutions to need ease management HIV treatment without harming its efficacy and safety. We report long- term results in patients switched, while virologically suppressed, combination dolutegravir (DTG) plus lamivudine (3TC). Methods This a prospective, clinical, uncontrolled cohort enrolling ART-experienced people living with (PLWH) HIV-RNA < 50 copies/ml for 6 months or longer, negative hepatitis B virus surface antigen, known M184V/I mutations. Kaplan-Meiers curves are used describe persistency virological suppression on therapy Cox regression model evaluate baseline characteristics risk stopping therapy. Results 218 individuals switched their regimen since 2015. mean estimated follow-up was 64.3 (95% CI 61.3–67.3) approximately 1000 patient/years. After 5 years follow-up, 77.1% were still DTG-3TC combination. No virologic failure detected throughout whole study period, only 15 subjects presented single isolated viral blips above copies/ml. Most stopped because reasons unrelated drugs (lost follow-up; patients’ decision; moved other Centers), but due unselected nature casuistry; 11 died mostly pre-existing co-morbidities (6 neoplastic diseases 2 end-stage liver disease). median CD4 count 669 cells/mcl (IQR 483–927). it raised 899 646–1160) (P 0.001) significant change CD8 counts that lowered from 767 532–1034) 683 538–988). Consequently, CD4/CD8 ratio varied 0.93 0.60–1.30) 1.15 0.77–1.45) 0.0001). A non-significant = 0.320) increment creatinine, 0.06 mg/dl magnitude, observed over follow-up. Conclusion These long-term reinforce durability good tolerability DTG-3TC. Our continue support recommended switch this 2DR as well-accepted option PLWH.