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Suárez-García I, Alejos B, Hernando V, Viñuela L, Vera García M, Rial-Crestelo D, Pérez Elías MJ, Albendín Iglesias H, Peraire J, Tiraboschi J, Díaz A, Moreno S, Jarrín I. Effectiveness and tolerability of dolutegravir/lamivudine for the treatment of HIV-1 infection in clinical practice. J Antimicrob Chemother 2023:7143330. [PMID: 37099559 DOI: 10.1093/jac/dkad102] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/17/2023] [Indexed: 04/27/2023] Open
Abstract
OBJECTIVES To assess the effectiveness and tolerability of dolutegravir (DTG)/lamivudine (3TC) among treatment-naive and virologically suppressed treatment-experienced individuals in the multicentre cohort of the Spanish HIV/AIDS Research Network (CoRIS) during the years 2018-2021. METHODS We used multivariable regression models to compare viral suppression (VS) [HIV RNA viral load (VL) <50 copies/mL] and the change in CD4 cell counts at 24 and 48 (±12) weeks after initiation with dolutegravir/lamivudine or other first-line ART regimens. RESULTS We included 2160 treatment-naive subjects, among whom 401 (18.6%) started with dolutegravir/lamivudine. The remaining subjects started bictegravir (BIC)/emtricitabine (FTC)/tenofovir alafenamide (TAF) (n = 949, 43.9%), DTG + FTC/tenofovir disoproxil fumarate (TDF) (n = 282, 13.1%), DTG/3TC/abacavir (ABC) (n = 255, 11.8%), darunavir (DRV)/cobicistat(COBI)/FTC/TAF (n = 147, 6.8%) and elvitegravir (EVG)/COBI/FTC/TAF (n = 126, 5.8%). At 24 and 48 weeks after starting dolutegravir/lamivudine, 91.4% and 93.8% of the subjects, respectively, achieved VS. The probability of achieving VS with dolutegravir/lamivudine was not significantly different compared with any other regimen at 24 or 48 weeks, with the exception of a lower chance of achieving VS at 24 weeks for DRV/COBI/FTC/TAF (adjusted OR: 0.47; 95% CI: 0.30-0.74) compared with dolutegravir/lamivudine.For the analysis of treatment-experienced virally suppressed subjects we included 1456 individuals who switched to dolutegravir/lamivudine, among whom 97.4% and 95.5% maintained VS at 24 and 48 weeks, respectively. During the first 48 weeks after dolutegravir/lamivudine initiation, 1.0% of treatment-naive and 1.5% of treatment-experienced subjects discontinued dolutegravir/lamivudine due to an adverse event. CONCLUSIONS In this large multicentre cohort, effectiveness and tolerability of dolutegravir/lamivudine were high among treatment-naive and treatment-experienced subjects.
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Affiliation(s)
- Inés Suárez-García
- Infectious Diseases Group, Department of Internal Medicine, Hospital Universitario Infanta Sofía, FIIB HUIS HHEN, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Department of Medicine, Universidad Europea, Madrid, Spain
| | | | - Victoria Hernando
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- HIV, STI and Hepatitis Surveillance Unit, National Center of Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Laura Viñuela
- Department of Microbiology, Hospital Universitario Clínico San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria Granada, Granada, Spain
| | - Mar Vera García
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | - David Rial-Crestelo
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- David Rial-Crestelo, HIV Unit, Hospital Universitario 12 de Octubre-Imas12, Madrid, Spain
| | - María Jesús Pérez Elías
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Helena Albendín Iglesias
- HIV and STI Unit, Department of Internal Medicine, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Joaquim Peraire
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Hospital Universitari de Tarragona Joan XXIII, IISPV, Tarragona, Spain
- Universitat Rovira i Virgili, Tarragona, Spain
| | - Juan Tiraboschi
- HIV Unit, Department of Infectious Diseases, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Asunción Díaz
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- HIV, STI and Hepatitis Surveillance Unit, National Center of Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Santiago Moreno
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Inma Jarrín
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain
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