IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Department of Health's Sciences, University of Genoa, Genoa, Italy.
New Microbiol. 2024 May;47(1):111-115.
Lamivudine (3TC)/dolutegravir (DTG) single tablet regimen (STR) has shown long-term efficacy and tolerability in people living with HIV (PLWH). Dolutegravir has been approved for use in children, while data on the efficacy of 3TC plus DTG in maintaining virological suppression in this population are still under evaluation. In this case series, we describe three children with perinatally acquired HIV who maintained virological suppression after switching antiretroviral therapy to DTG/3TC. We present three case reports of three children enrolled in the Italian Register for HIV Infection in Children: a 9-year-old boy, a 10-year-old girl, and a 2-year-old girl with perinatally acquired HIV who immediately started antiretroviral therapy with a three-drug regimen upon diagnosis, which occurred at delivery, after 6 months of life, and after 2 years of life, respectively. They achieved and maintain virological suppression after 1, 6, and 7 months of therapy, respectively; then a switch strategy was performed with a two-drug regimen with DTG/3TC STR at the age of 7 years for the first child and at the age of 9 years for the second, while the third was switched to a DTG plus 3TC not STR, owing to weight requirements, at the age of 2 years and 10 months. All children maintained virological suppression at last follow-up visit (January 2024), showing an excellent growth curve and maintaining good adherence and tolerability to DTG plus 3TC. A two-drug regimen with DTG/3TC demonstrated efficacy in maintaining virological suppression in a switch strategy in these children, with important advantages such as better tolerability and comfort of taking a single tablet once daily.
拉米夫定（3TC）/度鲁特韦（DTG）单片复方制剂（STR）在 HIV 感染者（PLWH）中显示出长期疗效和耐受性。DTG 已获准用于儿童，而关于 3TC 联合 DTG 在该人群中维持病毒学抑制的疗效数据仍在评估中。在本病例系列中，我们描述了 3 例通过母婴传播感染 HIV 的儿童，他们在转换为 DTG/3TC 抗逆转录病毒治疗后维持病毒学抑制。我们报告了 3 例在意大利儿童 HIV 感染登记处注册的儿童病例：1 例 9 岁男孩、1 例 10 岁女孩和 1 例 2 岁女孩，他们在出生时、6 个月大时和 2 岁大时分别被诊断为 HIV 感染，立即开始三药治疗方案。他们分别在治疗后 1、6 和 7 个月实现并维持病毒学抑制；然后在 7 岁时为第一个孩子和 9 岁时为第二个孩子采用 DTG/3TC STR 转换策略，而第三个孩子因体重要求，在 2 岁 10 个月时转换为 DTG 加 3TC 非 STR。所有儿童在最后一次随访（2024 年 1 月）时均维持病毒学抑制，表现出良好的生长曲线，并保持对 DTG 加 3TC 的良好依从性和耐受性。在这些儿童中，采用 DTG/3TC 的两药方案在转换策略中显示出维持病毒学抑制的疗效，具有更好的耐受性和服用每日一片的舒适度等重要优势。
