The DoDo experience: an alternative antiretroviral 2-drug regimen of doravirine and dolutegravir.
2-drug regimen
Antiretroviral therapy
Dolutegravir
Doravirine
HIV
Journal
Infection
ISSN: 1439-0973
Titre abrégé: Infection
Pays: Germany
ID NLM: 0365307
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
27
04
2023
accepted:
11
07
2023
medline:
27
11
2023
pubmed:
1
8
2023
entrez:
1
8
2023
Statut:
ppublish
Résumé
Currently available antiretroviral 2-drug regimen (2DR) fixed dose combinations may not be suitable for specific situations including the presence of resistance associated mutations (RAM) or drug - drug interactions (DDI). The data on the use of the non-nucleoside reverse transcriptase inhibitor doravirine (DOR) and the integrase inhibitor dolutegravir (DTG) as an alternative 2DR remain scarce. People living with HIV with DOR + DTG as a 2DR are being followed in a prospective observational study. This analysis describes 85 participants with a median age of 57 years. Median CD4-nadir was 173/µl and a majority (66%) had a history of HIV-associated or AIDS-defining conditions. Antiretroviral history was mostly extensive, and documentation of RAM was frequent. The main reasons for choosing DOR + DTG were DDI (29%), tolerability (25%), and cardiovascular risk reduction (21%). Plasma viral load at switch was < 50 copies/ml in all but 3 instances, median CD4 count was 600/µl. DOR + DTG was later changed to another regimen in 10 participants after a median of 265 days, the other 75 participants have remained on DOR + DTG for a median of 947 days. DOR + DTG as a 2DR proved to be a durable treatment option even in extensively pretreated individuals.
Sections du résumé
BACKGROUND
BACKGROUND
Currently available antiretroviral 2-drug regimen (2DR) fixed dose combinations may not be suitable for specific situations including the presence of resistance associated mutations (RAM) or drug - drug interactions (DDI). The data on the use of the non-nucleoside reverse transcriptase inhibitor doravirine (DOR) and the integrase inhibitor dolutegravir (DTG) as an alternative 2DR remain scarce.
METHODS
METHODS
People living with HIV with DOR + DTG as a 2DR are being followed in a prospective observational study.
RESULTS
RESULTS
This analysis describes 85 participants with a median age of 57 years. Median CD4-nadir was 173/µl and a majority (66%) had a history of HIV-associated or AIDS-defining conditions. Antiretroviral history was mostly extensive, and documentation of RAM was frequent. The main reasons for choosing DOR + DTG were DDI (29%), tolerability (25%), and cardiovascular risk reduction (21%). Plasma viral load at switch was < 50 copies/ml in all but 3 instances, median CD4 count was 600/µl. DOR + DTG was later changed to another regimen in 10 participants after a median of 265 days, the other 75 participants have remained on DOR + DTG for a median of 947 days.
CONCLUSION
CONCLUSIONS
DOR + DTG as a 2DR proved to be a durable treatment option even in extensively pretreated individuals.
Identifiants
pubmed: 37526898
doi: 10.1007/s15010-023-02075-y
pii: 10.1007/s15010-023-02075-y
pmc: PMC10665222
doi:
Substances chimiques
doravirine
913P6LK81M
dolutegravir
DKO1W9H7M1
Anti-Retroviral Agents
0
Oxazines
0
Anti-HIV Agents
0
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1823-1829Informations de copyright
© 2023. The Author(s).
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