Efficacy and tolerability of lamivudine plus dolutegravir compared with lamivudine plus boosted PIs in HIV-1 positive individuals with virologic suppression: a retrospective study from the clinical practice

• Published in: BMC infectious diseases 2019-01, Vol.19 (1), p.59-9, Article 59
• Main Authors: Borghetti, Alberto, Lombardi, Francesca, Gagliardini, Roberta, Baldin, Gianmaria, Ciccullo, Arturo, Moschese, Davide, Emiliozzi, Arianna, Belmonti, Simone, Lamonica, Silvia, Montagnani, Francesca, Visconti, Elena, De Luca, Andrea, Di Giambenedetto, Simona
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Anti-HIV Agents - administration & dosage; Anti-HIV Agents - adverse effects; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Antiretroviral Therapy, Highly Active - adverse effects; Antiviral drugs; Atazanavir Sulfate - therapeutic use; Biological products industry; Cholesterol; Cohort Studies; Darunavir; Darunavir - therapeutic use; Dolutegravir; Dosage and administration; Drug therapy; Drug Therapy, Combination; Dual therapy; Durability; Female; Health risks; Heterocyclic Compounds, 3-Ring - administration & dosage; Heterocyclic Compounds, 3-Ring - adverse effects; Highly active antiretroviral therapy; HIV; HIV Infections - drug therapy; HIV Infections - virology; HIV patients; HIV Seropositivity - drug therapy; HIV Seropositivity - virology; HIV-1 - drug effects; Human immunodeficiency virus; Humans; Lamivudine; Lamivudine - administration & dosage; Lamivudine - adverse effects; Lipids; Maintenance therapy; Male; Middle Aged; Mutation; Oxazines; Patient outcomes; Patients; Piperazines; Pyridones; Renal function; Retrospective Studies; Risk analysis; Risk factors; Ritonavir - therapeutic use; Switching; Tenofovir; Tenofovir - therapeutic use; Therapy; Toxicity; Treatment Outcome; Viral Load - drug effects
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-018-3666-8

Direct comparisons between lamivudine plus bPIs and lamivudine plus dolutegravir as maintenance strategies in virologically-suppressed HIV positive patients are lacking. Time to treatment discontinuation (TD) and virological failure (VF) were compared in a cohort of HIV+ patients on a virologically-effective ART starting lamivudine with either darunavir/r, atazanavir/r or dolutegravir. Changes in laboratory parameters were also evaluated. Four-hundred-ninety-four patients were analyzed (170 switching to darunavir/r, 141 to atazanavir/r, 183 to dolutegravir): median age was 49 years, with 8 years since ART start. Groups differed for age, HIV-risk factor, time since HIV-diagnosis and on ART, previous therapy and reasons for switching. Estimated proportions free from TD at week 48 and 96 were 79.8 and 48.3% of patients with darunavir/r, 87.0 and 70.9% with atazanavir/r, and 88.2 and 82.6% with dolutegravir, respectively (p