Joshi Kavita, Shinde Shital, Karatela Shifa, Mulkalwar Alhad
Department of Medicine, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Mumbai, IND.
Department of Medicine, Government Medical College and Hospital Miraj, Sangli, IND.
Cureus. 2024 Jun 17;16(6):e62522. doi: 10.7759/cureus.62522. eCollection 2024 Jun.
Background The emergence of dolutegravir (DTG) within antiretroviral therapy (ART) has drastically improved the management of HIV/AIDS, marking a shift toward a chronic manageable condition. Nevertheless, concerns persist regarding the real-world tolerability and adverse effects (AEs) of DTG. Objective This study aims to explore the clinical characteristics, adverse reactions, and adherence to treatment with DTG among HIV-positive individuals. Methods Through a prospective approach, we examined HIV-positive patients undergoing DTG-based ART regimens. Key parameters, including socio-demographic data, treatment adherence, and clusters of differentiation 4 (CD4) count, were evaluated. Enrolled patients were followed up for six months for the development of comorbidities and AEs. Results Initial observations indicate successful viral suppression and enhanced CD4 counts with DTG-based regimens, t(318)=2.0664, p=0.0392. However, a subset of participants experienced AEs such as neuropsychiatric symptoms (headaches and mood fluctuations), unintended weight gain, and other comorbidities linked to prolonged ART usage. Conclusion While DTG-based therapies offer substantial advantages in HIV/AIDS management, such as rapid viral suppression and reduced toxicity, ongoing vigilance for adverse effects, particularly neuropsychiatric symptoms and metabolic disturbances, is imperative for optimizing patient care. Further research is necessary to fully elucidate the safety profile of DTG in real-world scenarios and mitigate potential adverse reactions.
背景 在抗逆转录病毒疗法（ART）中出现的多替拉韦（DTG）极大地改善了对艾滋病毒/艾滋病的管理，标志着向慢性可控制疾病的转变。然而，对于DTG在现实世界中的耐受性和不良反应（AE）的担忧依然存在。目的 本研究旨在探讨艾滋病毒阳性个体中DTG的临床特征、不良反应及治疗依从性。方法 通过前瞻性方法，我们对接受基于DTG的ART方案的艾滋病毒阳性患者进行了检查。评估了关键参数，包括社会人口统计学数据、治疗依从性和分化簇4（CD4）计数。对入组患者随访6个月，观察合并症和AE的发生情况。结果 初步观察表明，基于DTG的方案可成功实现病毒抑制并提高CD4计数，t(318)=2.0664，p=0.0392。然而，一部分参与者出现了AE，如神经精神症状（头痛和情绪波动）、意外体重增加以及与长期使用ART相关的其他合并症。结论 虽然基于DTG的疗法在艾滋病毒/艾滋病管理中具有显著优势，如快速病毒抑制和降低毒性，但持续监测不良反应，尤其是神经精神症状和代谢紊乱，对于优化患者护理至关重要。有必要进行进一步研究，以全面阐明DTG在现实世界中的安全性概况并减轻潜在的不良反应。
