Cicalini Stefania, Lanini Simone, Gagliardini Roberta, Bellagamba Rita, Vergori Alessandra, Mastrorosa Ilaria, Mazzotta Valentina, Esvan Rozenn, Plazzi Maria Maddalena, Ottou Sandrine, Grilli Elisabetta, De Zottis Federico, Fusto Marisa, Paulicelli Jessica, Antinori Andrea
Systemic and Immune Depression-Associated Infections Unit, Clinical Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Roma, Italy.
Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy.
Pharmaceuticals (Basel). 2024 Dec 17;17(12):1706. doi: 10.3390/ph17121706.
With advances in antiretroviral therapy for HIV treatment, newer drug combinations provide improved efficacy, safety, and compliance. This study evaluates switching to a regimen of doravirine (DOR), tenofovir disoproxil fumarate (TDF), and lamivudine (3TC) in a cohort of people living with HIV (PLWH). this Italian retrospective study included 426 PLWH who switched from rilpivirine (RPV)/TDF/emtricitabine (FTC) to DOR/3TC/TDF. The analysis focused on treatment effectiveness, safety, and metabolic and renal markers. this study reports a treatment failure (defined as virological failure or discontinuation of the regimen) rate of 2.34% (95% confidence interval, 1.28-4.50%), with significant improvement in CD4 counts (+49.93 cells/µL, < 0.001). Notably, the switch to DOR/3TC/TDF did not result in adverse metabolic effects or significant changes in renal function. Analysis of lipid profiles showed stabilization in the majority of PLWH. this study indicates that switching to a DOR/3TC/TDF from RPV/TDF/FTC is an effective and well-tolerated option for PLWH, with benefits in terms of maintaining viral suppression, CD4 count recovery, and metabolic health, without evidence of renal impairment. These results support the continued use of DOR/3TC/TDF as part of HIV treatment strategies and highlight the need for ongoing research to refine ART regimens for different populations.
随着用于治疗HIV的抗逆转录病毒疗法的进展，更新的药物组合在疗效、安全性和依从性方面都有所改善。本研究评估了一组HIV感染者（PLWH）改用多瑞韦（DOR）、替诺福韦酯（TDF）和拉米夫定（3TC）方案的情况。这项意大利的回顾性研究纳入了426名从利匹韦林（RPV）/TDF/恩曲他滨（FTC）改用DOR/3TC/TDF的PLWH。分析重点关注治疗效果、安全性以及代谢和肾脏指标。本研究报告的治疗失败率（定义为病毒学失败或停用该方案）为2.34%（95%置信区间，1.28 - 4.50%），CD4细胞计数有显著改善（增加49.93个细胞/µL，P < 0.001）。值得注意的是，改用DOR/3TC/TDF并未导致不良代谢影响或肾功能的显著变化。对血脂谱的分析表明，大多数PLWH的血脂情况稳定。本研究表明，从RPV/TDF/FTC改用DOR/3TC/TDF对PLWH是一种有效且耐受性良好的选择，在维持病毒抑制、CD4细胞计数恢复和代谢健康方面有好处，且无肾功能损害的证据。这些结果支持继续将DOR/3TC/TDF用作HIV治疗策略的一部分，并强调需要持续开展研究以优化针对不同人群的抗逆转录病毒治疗（ART）方案。
