Background: Results from clinical trials and observational studies suggest that dolutegravir plus lamivudine could be an effective and well-tolerated option for simplification in HIV-1-positive patients. We aimed to assess long-time efficacy and safety in our multicenter cohort. Methods: This was a retrospective study enrolling HIV-1-infected, virologically suppressed patients switching to dolutegravir + lamivudine. We performed survival analysis to evaluate time to virological failure (VF, defined by a single HIV-RNA >= 1000 copies/mL or by 2 consecutive HIV-RNA >= 50 copies/mL) and treatment discontinuation (defined as the interruption of either 3TC or dolutegravir), assessing predictors via Cox regression analyses. Results: Seven-hundred eighty-five patients were considered for the analysis: 554 were men (70.6%), with a median age of 52 years (interquartile range 45-58 years). Estimated probabilities of maintaining virological suppression at weeks 96, 144, and 240 were 97.7% (SD +/- 0.6), 96.9% (SD +/- 0.8), and 96.4% (SD +/- 0.9), respectively. A non-B HIV subtype (P = 0.014) and a previous VF (P = 0.037) resulted predictors of VF. We did not observe differences in probability of VF in people living with HIV with an M184V resistance mutation (P = 0.689); however, in a deeper analysis, M184V mutation was a predictor of VF (P = 0.038) in patients with time of virological suppression <88 months. Estimated probabilities of remaining on study regimen at 96, 144, and 240 weeks were 82.9% (SD +/- 1.4), 79.7% (SD +/- 1.6) and 74.3% (SD +/- 2.2), respectively. Conclusions: Our findings show the long-term efficacy and tolerability of dolutegravir plus lamivudine in virologically suppressed patients.

Ciccullo, A., Borghi, V., Giacomelli, A., Cossu, M. V., Sterrantino, G., Latini, A., Giacometti, A., De Vito, A., Gennari, W., Madeddu, G., Capetti, A., D'Ettorre, G., Mussini, C., Rusconi, S., Di Giambenedetto, S., Baldin, G., Five Years With Dolutegravir Plus Lamivudine as a Switch Strategy: Much More Than a Positive Finding, <<JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES>>, 2021; 88 (3): 234-237. [doi:10.1097/QAI.0000000000002787] [http://hdl.handle.net/10807/193225]

Five Years With Dolutegravir Plus Lamivudine as a Switch Strategy: Much More Than a Positive Finding

Di Giambenedetto, Simona;
2021

Abstract

Background: Results from clinical trials and observational studies suggest that dolutegravir plus lamivudine could be an effective and well-tolerated option for simplification in HIV-1-positive patients. We aimed to assess long-time efficacy and safety in our multicenter cohort. Methods: This was a retrospective study enrolling HIV-1-infected, virologically suppressed patients switching to dolutegravir + lamivudine. We performed survival analysis to evaluate time to virological failure (VF, defined by a single HIV-RNA >= 1000 copies/mL or by 2 consecutive HIV-RNA >= 50 copies/mL) and treatment discontinuation (defined as the interruption of either 3TC or dolutegravir), assessing predictors via Cox regression analyses. Results: Seven-hundred eighty-five patients were considered for the analysis: 554 were men (70.6%), with a median age of 52 years (interquartile range 45-58 years). Estimated probabilities of maintaining virological suppression at weeks 96, 144, and 240 were 97.7% (SD +/- 0.6), 96.9% (SD +/- 0.8), and 96.4% (SD +/- 0.9), respectively. A non-B HIV subtype (P = 0.014) and a previous VF (P = 0.037) resulted predictors of VF. We did not observe differences in probability of VF in people living with HIV with an M184V resistance mutation (P = 0.689); however, in a deeper analysis, M184V mutation was a predictor of VF (P = 0.038) in patients with time of virological suppression <88 months. Estimated probabilities of remaining on study regimen at 96, 144, and 240 weeks were 82.9% (SD +/- 1.4), 79.7% (SD +/- 1.6) and 74.3% (SD +/- 2.2), respectively. Conclusions: Our findings show the long-term efficacy and tolerability of dolutegravir plus lamivudine in virologically suppressed patients.
2021
Inglese
Ciccullo, A., Borghi, V., Giacomelli, A., Cossu, M. V., Sterrantino, G., Latini, A., Giacometti, A., De Vito, A., Gennari, W., Madeddu, G., Capetti, A., D'Ettorre, G., Mussini, C., Rusconi, S., Di Giambenedetto, S., Baldin, G., Five Years With Dolutegravir Plus Lamivudine as a Switch Strategy: Much More Than a Positive Finding, <<JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES>>, 2021; 88 (3): 234-237. [doi:10.1097/QAI.0000000000002787] [http://hdl.handle.net/10807/193225]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/193225
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