Piñeiro C, Policarpo S, Caldas C, Santos L, Augusto I, DiMondi V P, Serrão R
Centro Hospitalar Universitário de São João, Porto, Portugal.
ViiV Healthcare, Algés, Portugal.
HIV Med. 2025 Jan;26(1):36-43. doi: 10.1111/hiv.13699. Epub 2024 Sep 6.
People living with HIV face several challenges as they age, including the potential for polypharmacy and increased susceptibility to drug-related adverse effects. Thus, effective and well-tolerated regimens with minimal or no drug interactions would be useful in this population. We present real-world effectiveness and safety data for individuals aged >50 years who achieved virological suppression (HIV-1 RNA <50 copies/mL) and switched to dolutegravir/lamivudine (DTG/3TC).
This retrospective, observational, single-centre study conducted in Portugal included individuals aged >50 years who switched to DTG/3TC while virologically suppressed and had ≥12 months of follow-up. Proportions of individuals maintaining virological suppression were described at 12 months; CD4+ cell counts were described at baseline and 12 months. Descriptive subgroup analyses were performed based on age, sex assigned at birth, and availability of historical genotypic resistance results.
Overall, 538 individuals aged >50 years were included (74% male; mean age, 62 years; mean time on previous therapy, 160 months). High proportions (intention-to-treat population, 97%; on-treatment population, 98%) of individuals who switched to DTG/3TC maintained virological suppression through 12 months of follow-up. CD4+ cell counts remained stable (mean baseline: 727 cells/mm [range 94-2371]; mean month 12: 742 cells/mm [range 99-2659]). No individuals experienced virological failure. Nine (2%) individuals discontinued DTG/3TC for non-treatment-related reasons. Proportions with virological suppression at month 12 were similar between on-treatment subgroups by age, sex assigned at birth, and historical genotypic resistance results availability.
DTG/3TC demonstrated robust effectiveness and a good safety profile in individuals aged >50 years with virological suppression in Portugal.
随着年龄增长，HIV感染者面临诸多挑战，包括多重用药的可能性以及对药物相关不良反应易感性增加。因此，具有最小或无药物相互作用且耐受性良好的有效治疗方案对该人群会很有用。我们展示了年龄大于50岁且实现病毒学抑制（HIV-1 RNA<50拷贝/毫升）并换用多替拉韦/拉米夫定（DTG/3TC）的个体的真实世界有效性和安全性数据。
这项在葡萄牙进行的回顾性、观察性、单中心研究纳入了年龄大于50岁且在病毒学抑制状态下换用DTG/3TC并随访≥12个月的个体。描述了12个月时维持病毒学抑制的个体比例；在基线和12个月时描述了CD4+细胞计数。根据年龄、出生时指定的性别以及历史基因型耐药结果的可用性进行描述性子组分析。
总体而言，纳入了538名年龄大于50岁的个体（74%为男性；平均年龄62岁；之前治疗的平均时间为160个月）。换用DTG/3TC的个体中有高比例（意向性治疗人群为97%；治疗中人群为98%）在12个月的随访期内维持病毒学抑制。CD4+细胞计数保持稳定（平均基线：727个细胞/立方毫米[范围94 - 2371]；平均第12个月：742个细胞/立方毫米[范围99 - 2659]）。没有个体经历病毒学失败。9名（2%）个体因非治疗相关原因停用DTG/3TC。按年龄、出生时指定的性别以及历史基因型耐药结果可用性划分的治疗中各亚组在第12个月时的病毒学抑制比例相似。
在葡萄牙，DTG/3TC在年龄大于50岁且实现病毒学抑制的个体中显示出强大的有效性和良好的安全性。
