Suárez-García Inés, Alejos Belén, Moreno Cristina, Martín Torres Juan, Masiá Mar, García-Fraile Lucio J, Riera Melchor, Dalmau David, Rodríguez-Rosado Rafael, Muga Roberto, Moreno Santiago, Jarrín Inma
Infectious Diseases Group, Department of Internal Medicine, Hospital Universitario Infanta Sofia, FIIB HUIS HUHEN, Madrid, Spain.
CIBER de Enfermedades Infecciosas (CIBERINFEC), Carlos III Health Institute, Madrid, Spain.
J Antimicrob Chemother. 2025 Mar 3;80(3):682-691. doi: 10.1093/jac/dkae456.
To evaluate the long-term effectiveness, persistence and tolerability of dolutegravir (DTG)/lamivudine (3TC), compared with the most frequently prescribed first-line treatment regimens, among antiretroviral-naive people with HIV from CoRIS, a multicentre cohort in Spain, in 2018-23.
We used multivariable regression models to compare viral suppression (VS) (HIV RNA viral load <50 copies/mL), change in CD4 cell counts, persistence and treatment discontinuations due to adverse events (AEs), at 96 (±24) weeks after treatment initiation.
Of 2359 participants, DTG/3TC was prescribed in 472 (20.0%), bictegravir/tenofovir alafenamide (TAF)/emtricitabine (FTC) in 1134 (48.1%), DTG + tenofovir disoproxil fumarate/FTC in 300 (12.7%), DTG/abacavir/3TC in 273 (11.6%) and darunavir/cobicistat/TAF/FTC in 180 (7.6%). At 96 weeks from treatment initiation, 94.0% of participants initiating with DTG/3TC achieved VS, and the mean increase in CD4 cell counts was 295.5 cells/μL (95% CI: 269.9-321.1). During the first 96 weeks after DTG/3TC initiation, 9.8% and 1.3% discontinued their initial regimen, overall and due to AEs, respectively. In multivariable analyses, we did not find significant differences in VS or increase in CD4 cell counts among participants initiating with DTG/3TC compared with other regimens. Initiating ART with a regimen other than DTG/3TC was associated with a higher risk of treatment discontinuation, overall and due to AEs.
Among treatment-naive people with HIV from this large multicentre cohort, DTG/3TC had similar effectiveness and better persistence and tolerability than those of the most frequently prescribed first-line regimens at 96 weeks.
在西班牙一个多中心队列CoRIS于2018 - 2023年纳入的初治HIV感染者中，评估多替拉韦（DTG）/拉米夫定（3TC）与最常用的一线治疗方案相比的长期有效性、持续性和耐受性。
我们使用多变量回归模型，比较治疗开始后96（±24）周时的病毒抑制（VS）（HIV RNA病毒载量<50拷贝/mL）、CD4细胞计数变化、持续性以及因不良事件（AE）导致的治疗中断情况。
在2359名参与者中，472人（20.0%）接受了DTG/3TC治疗，1134人（48.1%）接受了比克替拉韦/替诺福韦艾拉酚胺（TAF）/恩曲他滨（FTC）治疗，300人（12.7%）接受了DTG + 富马酸替诺福韦二吡呋酯/FTC治疗，273人（11.6%）接受了DTG/阿巴卡韦/3TC治疗，180人（7.6%）接受了达芦那韦/考比司他/TAF/FTC治疗。治疗开始后96周时，开始接受DTG/3TC治疗的参与者中有94.0%实现了病毒抑制，CD4细胞计数的平均增加为295.5个细胞/μL（95%CI：269.9 - 321.1）。在开始DTG/3TC治疗后的前96周内，分别有9.8%和1.3%的参与者总体上和因不良事件而停用了初始治疗方案。在多变量分析中，与其他方案相比，开始接受DTG/3TC治疗的参与者在病毒抑制或CD4细胞计数增加方面未发现显著差异。与DTG/3TC以外的方案开始抗逆转录病毒治疗与总体上以及因不良事件导致的治疗中断风险较高相关。
在这个大型多中心队列的初治HIV感染者中，DTG/3TC在96周时具有与最常用的一线方案相似的有效性，以及更好的持续性和耐受性。
