Virological response and resistance profile in highly treatment‐experienced HIV‐1‐infected patients switching to dolutegravir plus boosted darunavir in clinical practice

Objectives We evaluated the virological response and resistance profile in combined antiretroviral therapy (cART)‐experienced HIV‐1‐infected patients starting a dual therapy with dolutegravir (DTG) and boosted darunavir (bDRV) for the first time. Methods Survival analyses were used to evaluate virol...

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Bibliographic Details
Published in:HIV medicine 2021-07, Vol.22 (6), p.519-525
Main Authors: Armenia, Daniele, Bouba, Yagai, Gagliardini, Roberta, Fabeni, Lavinia, Borghi, Vanni, Berno, Giulia, Vergori, Alessandra, Cicalini, Stefania, Mussini, Cristina, Antinori, Andrea, Ceccherini‐Silberstein, Francesca, Perno, Carlo Federico, Santoro, Maria Mercedes
Format: Article
Language:English
Subjects:
Anti-HIV Agents - pharmacology
Anti-HIV Agents - therapeutic use
Antiretroviral agents
Antiretroviral therapy
Darunavir
dolutegravir
drug resistance
dual therapy
genotypic susceptibility score
Heterocyclic Compounds, 3-Ring
HIV
HIV Infections - drug therapy
HIV-1 - genetics
HIV‐1
Human immunodeficiency virus
Humans
Integrase
Mutation
Oxazines
Patients
Piperazines
Protease
Protease inhibitors
Proteinase inhibitors
Pyridones
Retrospective Studies
RNA-directed DNA polymerase
Therapy
Viral Load
virological response
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Summary:Objectives We evaluated the virological response and resistance profile in combined antiretroviral therapy (cART)‐experienced HIV‐1‐infected patients starting a dual therapy with dolutegravir (DTG) and boosted darunavir (bDRV) for the first time. Methods Survival analyses were used to evaluate virological success (VS) and virological rebound (VR) in viraemic and virologically suppressed patients, respectively. Major resistance mutations (MRMs) and genotypic susceptibility score (GSS) were evaluated at baseline and after switch. Results Overall, 130 patients [62 (47.7%) viraemic; 68 (52.3%) virologically suppressed] were retrospectively analysed. At the moment of switch, 81.5% accumulated one or more MRM [protease inhibitor (PI), 35.7%; nucleoside(t)ide reverse transcriptase inhibitor (NRTI), 77.5%; non‐NRTI, 69.0%; integrase inhibitor (INI), 10.1%), but 77.7% harboured strains fully susceptible to DTG + bDRV. In viraemic patients, the overall probability of VS by 12 months of treatment was 91.7%. In virologically suppressed patients, the overall probability of VR was 10.5% by 24 months after therapy start. Patients with previous time under virological suppression ≤ 6 months showed a higher VR probability compared with others (37.5% vs. 6.7%, P 
ISSN:1464-2662
1468-1293
DOI:10.1111/hiv.13062