University of Bristol Medical School, Bristol, UK.
North Bristol NHS Trust, Bristol, UK.
HIV Med. 2019 Oct;20(9):634-637. doi: 10.1111/hiv.12781. Epub 2019 Jul 23.
The aim of the study was to evaluate the efficacy of dual therapy with lamivudine (3TC), with dose adjustment for renal function, and dolutegravir (DTG) in a subgroup of patients fully suppressed on treatment who were switched because of concerns about comorbidity and toxicity on their current triple drug regimen.
A retrospective evaluation of clinical and pathological parameters from an electronic patient record from a single centre was carried out.
There were no virological failures in 52 patients with a median age of 60.5 years. The median duration of follow-on dual therapy was 2.29 years (28 months; range 1.10-3.34 years). In 25 of 52 (48%) cases, the dose of 3TC was adjusted taking into account reduced renal function, and none of these patients experienced virological failure. Four additional patients discontinued early, because of side effects of the switch, with no failure.
This retrospective review suggests that 3TC and DTG may be effective in controlling viral load in older patients with comorbidities. This regimen appears to be a useful option in the context of comorbidities (including renal impairment) and polypharmacy in older patients. However, this review has been conducted in one centre and in a small population of patients. Therefore, further multicentre trials involving larger populations of patients are needed.
本研究旨在评估拉米夫定（3TC）联合多替拉韦（DTG）双药治疗的疗效，该方案对肾功能进行剂量调整，适用于因当前三联药物方案的合并症和毒性而顾虑停药的完全抑制病毒载量的患者亚组。
对来自单中心电子病历的临床和病理参数进行回顾性评估。
52 名中位年龄为 60.5 岁的患者中无病毒学失败。后续双药治疗的中位时间为 2.29 年（28 个月；范围 1.10-3.34 年）。在 52 例中有 25 例（48%）考虑到肾功能降低调整了 3TC 剂量，这些患者中无病毒学失败。另有 4 例因转换副作用而提前停药，无失败。
本回顾性研究表明，拉米夫定和多替拉韦可能有效控制合并症老年患者的病毒载量。在合并症（包括肾功能损害）和老年患者多药治疗的情况下，该方案似乎是一种有用的选择。但是，本研究仅在一个中心和一小部分患者中进行。因此，需要进行涉及更多患者的多中心试验。
