Unit of Infectious Diseases, Instituto de Investigación Biosanitario de Granada (IBS-Granada), Virgen de las Nieves University Hospital, 18014 Granada, Spain.
Department of Infectious Diseases, Virgen del Rocio University Hospitals, 41013 Seville, Spain.
Viruses. 2024 Feb 6;16(2):259. doi: 10.3390/v16020259.
The continuous pharmacological advances in antiretroviral treatment (ART) and the increasing understanding of HIV drug resistance has led to a change in the paradigm of ART optimization in the setting of the viral suppression of treatment-experienced patients with the emerging evidence of the effectiveness and safety of dual therapies. The aim of this study is to determine the antiviral efficacy and safety of switching to Dolutegravir + Lamivudine in people living with HIV, and to analyze the rate of patients with virologic failure (VF). A total of 200 patients were included with a median age of 51 years, 189 cells/µL of nadir CD4+, 13 years on ART and four previous ART regimens. Among the 168 patients who completed a follow-up at 48 weeks, a total of five VFs occurred, resulting in a 2.98% (5/168) VF rate. The results of the intention-to-treat analysis were a VF rate of 2.54% (5/197), and the rate of patients/year with viral suppression was 98.3% (298/303) in the observed data analysis. We observed a significant improvement in mean CD4 lymphocytes, the CD4/CD8 ratio and lipid profiles. The optimization of ART to DTG plus 3TC is a cost-effective switch option for treatment-experienced HIV patients, and also improves their lipid profiles.
抗逆转录病毒治疗（ART）的不断药理学进展以及对 HIV 耐药性的不断深入了解，导致在治疗经验丰富的患者病毒抑制的背景下，对 ART 优化的范例发生了变化，出现了双重疗法有效性和安全性的新兴证据。本研究旨在确定将 Dolutegravir + Lamivudine 转换为治疗 HIV 感染者的抗病毒疗效和安全性，并分析病毒学失败（VF）患者的比率。共纳入 200 名患者，中位年龄为 51 岁，CD4+ 最低点为 189 个细胞/µL，接受 ART 治疗 13 年，接受了 4 种以前的 ART 方案。在完成 48 周随访的 168 名患者中，共有 5 例发生 VF，VF 发生率为 2.98%（5/168）。意向治疗分析的结果为 VF 发生率为 2.54%（5/197），在观察数据分析中，病毒抑制的患者/年比率为 98.3%（298/303）。我们观察到 CD4 淋巴细胞、CD4/CD8 比值和血脂谱的平均水平显著改善。将 ART 优化为 DTG 加 3TC 是一种针对治疗经验丰富的 HIV 患者具有成本效益的转换选择，并且还改善了他们的血脂谱。
