Koay Wei Li Adeline, Sadler Eleanor D, Ferrer Kathleen, Rakhmanina Natella Y
Division of Infectious Diseases, Children's National Hospital, Washington, District of Columbia, USA
The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
BMJ Case Rep. 2021 Nov 2;14(11):e243685. doi: 10.1136/bcr-2021-243685.
We report a case of sustained viral suppression with dolutegravir monotherapy in a treatment-experienced adult with perinatally acquired HIV. The patient had recurrent pancreatitis with multiple antiretroviral drugs, leading to discontinuation of antiretroviral therapy for several years. She was ultimately initiated on dolutegravir monotherapy two times per day via a gastrostomy tube. She did not develop any integrase strand transfer inhibitor mutations during the first 2 years on dolutegravir monotherapy. The patient has successfully maintained prolonged viral suppression for over 3 years with intermittent blips secondary only to intermittent medical issues. This case is unique in describing a highly treatment-experienced young adult with perinatal HIV infection who has been virally suppressed on dolutegravir monotherapy for a prolonged follow-up of 156 weeks.
我们报告了一例在一名有围产期获得性HIV且有治疗经验的成人中使用多替拉韦单药治疗实现持续病毒抑制的病例。该患者使用多种抗逆转录病毒药物时反复发生胰腺炎，导致抗逆转录病毒治疗中断数年。她最终通过胃造瘘管开始每日两次使用多替拉韦单药治疗。在多替拉韦单药治疗的前两年中，她未出现任何整合酶链转移抑制剂突变。该患者已成功维持超过3年的长期病毒抑制，仅因间歇性医疗问题出现间歇性病毒载量波动。该病例的独特之处在于，描述了一名有高度治疗经验的围产期HIV感染青年成人，其在多替拉韦单药治疗下实现病毒抑制，并进行了长达156周的长期随访。
