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

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/23465

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/23465

Title:	Dual therapy with dolutegravir plus boosted protease inhibitor as maintenance or salvage therapy in highly experienced people living with HIV
Authors:	Lee, YL;Lin, KY;Cheng, SH;Lu, PL;Wang, NC;Ho, MW;Yang, CJ;Liou, BH;Tang, HJ;Huang, SS;Huang, SH;Chen, TC;Lin, CY;Lin, SP;Lee, YT;Hung, CC
Keywords:	Integrase strand transfer inhibitor;Two-drug regimen;Antiretroviral resistance;Weight gain;Dyslipidaemia
Date:	2021
Issue Date:	2022-08-05T09:37:45Z (UTC)
Publisher:	ELSEVIER
ISSN:	0924-8579
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.
URI:	http://dx.doi.org/10.1016/j.ijantimicag.2021.106403 https://www.webofscience.com/wos/woscc/full-record/WOS:000684980600016 https://ir.csmu.edu.tw:8080/handle/310902500/23465
Relation:	INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS ,2021,v58,issue 3
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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