Farinacci Damiano, Ciccullo Arturo, Lombardi Francesca, Moschese Davide, D'Angelillo Anna, Iannone Valentina, Lamanna Francesco, Passerotto Rosa Anna, Giambenedetto Simona Di
Istituto Clinica di Malattie Infettive, 96983Università Cattolica del Sacro Cuore, Rome, Italy.
UOC Malattie Infettive, Ospedale S. Salvatore, L'Aquila, Rome, Italy.
Antivir Ther. 2021 May;26(3-5):79-83. doi: 10.1177/13596535211056556. Epub 2021 Oct 25.
Doravirine (DOR) is a non-nucleoside reverse transcriptase inhibitor (NNRTI) approved for HIV-1 infection treatment. Because of its genetic barrier, DOR appears to be a good alternative in switch strategies compared to other NNRTI. Our aim was to evaluate the percentage of people living with HIV (PLWHIV) followed in our center who could be eligible to a DOR-based regimen.
We collected data from all treatment-experienced PLWHIV, never exposed to DOR and with a demonstrated virological suppression. We analyzed previous genotypic analyses, clinical history, and previous exposure to NNRTIs.
We analyzed data from 653 patients, whose characteristics are shown in Table 1. 59% of them presented no resistance mutation (RAM) at genotypic analysis. The most common DOR-related RAM were V106A, Y181V, and Y188L. We also analyzed RAM that can possibly interfere with combination therapy (mostly K65R and M184V). In the end, 81.8% of our patients results to be eligible for a DOR-based therapy regimen.
DOR represents a good option for switch strategies in virological suppressed PLWHIV. It seems to have a higher genetic barrier and a lower risk for resistance mutation development compared to other NNRTI. In our cohort, we found 81.8% of patients who could be eligible for a regimen containing DOR and almost 2/3 of patients who can be treated with the fixed-dose combination DOR/3TC/TDF.
多拉韦林（DOR）是一种被批准用于治疗HIV-1感染的非核苷类逆转录酶抑制剂（NNRTI）。由于其基因屏障，与其他NNRTI相比，多拉韦林在换药策略中似乎是一个不错的选择。我们的目的是评估在我们中心接受随访的符合基于多拉韦林治疗方案条件的HIV感染者（PLWHIV）的比例。
我们收集了所有有治疗经验、从未接触过多拉韦林且病毒学得到抑制的PLWHIV的数据。我们分析了既往的基因分析、临床病史以及既往接触NNRTIs的情况。
我们分析了653例患者的数据，其特征见表1。其中59%的患者在基因分析中未出现耐药突变（RAM）。最常见的与多拉韦林相关的RAM是V106A、Y181V和Y188L。我们还分析了可能干扰联合治疗的RAM（主要是K65R和M184V）。最终，我们81.8%的患者符合基于多拉韦林的治疗方案。
对于病毒学得到抑制的PLWHIV，多拉韦林是换药策略的一个不错选择。与其他NNRTI相比，它似乎具有更高的基因屏障和更低的耐药突变发生风险。在我们的队列中，我们发现81.8%的患者符合含多拉韦林方案的条件，近2/3的患者可以使用固定剂量复方制剂多拉韦林/拉米夫定/替诺福韦治疗。
