Dual therapy with dolutegravir plus boosted protease inhibitor as maintenance or salvage therapy in highly experienced people living with HIV

doi:10.1016/j.ijantimicag.2021.106403

CNU IR > Pharmacy and Science > Dept. of Health and Nutrition (including master's program) > Periodical Articles > Item 310902800/34377

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Title:	Dual therapy with dolutegravir plus boosted protease inhibitor as maintenance or salvage therapy in highly experienced people living with HIV
Authors:	Lee, Yu-Lin Lin, Kuan-Yin Cheng, Shu-Hsing Lu, Po-Liang Wang, Ning-Chi Ho, Mao-Wang Yang, Chia-Jui Liou, Bo-Huang Tang, Hung-Jen Huang, Shie-Shian Huang, Sung-Hsi Chen, Tun-Chieh Lin, Chi-Ying Lin, Shih-Ping Lee, Yuan-Ti Hung, Chien-Ching
Contributors:	Changhua Christian Hosp, Dept Internal Med, Changhua Natl Chung Hsing Univ, Inst Genom & Bioinformat Chung Shan Med Univ, Sch Med Natl Taiwan Univ Hosp, Dept Med, Jin Shan Branch Taoyuan Gen Hosp, Dept Infect Dis, Minist Hlth & Welf Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Internal Med Kaohsiung Med Univ, Coll Med Triserv Gen Hosp, Natl Def Med Ctr, Dept Internal Med China Med Univ Hosp, Dept Internal Med Far Eastern Mem Hosp, Dept Internal Med Natl Yang Ming Chiao Tung Univ, Sch Med Hsinchu MacKay Mem Hosp, Dept Internal Med Chi Mei Med Ctr, Dept Internal Med Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Keelung Chang Gung Mem Hosp, Dept Internal Med Natl Taiwan Univ Hosp, Dept Internal Med, Hsin Chu Branch Natl Taiwan Univ, Dept Trop Med & Parasitol, Coll Med Kaohsiung Municipal Tung Hosp, Dept Internal Med Natl Taiwan Univ Hosp, Dept Internal Med, Yun Lin Branch Taichung Vet Gen Hosp, Dept Internal Med, Sect Infect Dis Chung Shan Med Univ Hosp, tDept Internal Med Natl Taiwan Univ Hosp, Dept Internal Med
Keywords:	Integrase strand transfer inhibitor Two-drug regimen Antiretroviral resistance Weight gain Dyslipidaemia
Date:	2021
Issue Date:	2023-11-11 11:48:13 (UTC+8)
Publisher:	ELSEVIER
Abstract:	Real-world experience with dolutegravir (DTG) plus boosted protease inhibitor (bPI) as a two-drug regimen is limited for highly experienced HIV-positive patients with virological failure or intolerance to antiretroviral therapy. Patients receiving DTG plus bPI between September 2016 and June 2019 at 15 designated hospitals for HIV care in Taiwan were retrospectively included in this study. A standardised case record form was used to collect clinical data. The primary endpoint was virological response, defined as achieving or maintaining plasma HIV-RNA <50 copies/mL at Week 48. A total of 77 patients were included; 58 (75.3%) had documented genotypic resistance to 1-4 antiretroviral classes. The most commonly used PI was darunavir (87.0%; 67/77). Seven patients (9.1%) had no virological data at Week 48, including three with loss to follow-up, one severe hyperlipidaemia, one renal failure and cardiovascular disease, one superimposed HBV infection and one death from anal cancer. The virological response rate increased from 59.7% at baseline to 90.9% at Week 24 and 85.7% at Week 48. The only patient (1.3%) with virological failure at Week 48 had poor adherence and baseline low-level resistance to darunavir with resistance-associated mutations at M46L, I50V and V82A. Compared with baseline, mean total cholesterol increased by 20.1 mg/dL and weight by 2.8 kg at Week 48, while the estimated glomerular filtration rate decreased by 14.4 mL/min/1.73m(2) (both P < 0.05). We conclude that a two-drug regimen containing DTG plus bPI was effective in highly-experienced HIV-positive patients, but metabolic impact and weight gain should be closely monitored. (C) 2021 Published by Elsevier Ltd.
Relation:	INT J ANTIMICROB AG, v.58, n.3, pp.106403
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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