Wang Qing, Xie Xiaoxin, Fu Yanhua, Yang Xiaoyan, Gan Lin, Ma Shujing, Jiao Pengzhu, Wu Muli, Li Jun, Long Hai
School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou, China.
Department of Infection, Guiyang Public Health Clinical Center, Guiyang, Guizhou, China.
Front Med (Lausanne). 2025 Aug 29;12:1630960. doi: 10.3389/fmed.2025.1630960. eCollection 2025.
Evidence regarding the use of dolutegravir plus lamivudine (DTG + 3TC) among patients with HIV infection who present late remains limited. This study aimed to evaluate the effectiveness and safety of DTG + 3TC therapy in patients with late presentation in Southwest China.
This single-center, retrospective cohort study included patients with late presentation who initiated DTG + 3TC anti-retroviral therapy (ART) between January 2020 and July 2023 ( = 176). Changes in immunologic and metabolic parameters as well as liver and kidney function, were assessed. The primary endpoint was the proportion of participants with HIV-1 RNA < 50 copies/mL at week 48. Late presentation was defined as CD4 < 350 cells/μL or the presence of AIDS-defining conditions.
At weeks 24 and 48, 83.0% (146/176) and 90.9% (160/176) of the patients achieved HIV-1 RNA levels <50 copies/mL, respectively. At week 48, the median CD4 count increased by 139.5 cells/μL (120.5-158.5), and the CD4/CD8 ratio increased by 0.2 (0.1-0.3) ( < 0.001). No patient discontinued treatment owing to adverse events during the observation period.
DTG + 3TC demonstrated high virologic efficacy and good tolerability in patients with late presentation. However, the regimen may be associated with an increase in lipid levels and weight, highlighting the need for regular monitoring.
对于晚期就诊的HIV感染患者使用多替拉韦加拉米夫定（DTG + 3TC）的证据仍然有限。本研究旨在评估DTG + 3TC疗法在中国西南部晚期就诊患者中的有效性和安全性。
这项单中心回顾性队列研究纳入了2020年1月至2023年7月期间开始接受DTG + 3TC抗逆转录病毒治疗（ART）的晚期就诊患者（n = 176）。评估免疫和代谢参数以及肝肾功能的变化。主要终点是第48周时HIV-1 RNA <50拷贝/mL的参与者比例。晚期就诊定义为CD4 < 350细胞/μL或存在艾滋病定义的疾病。
在第24周和第48周，分别有83.0%（146/176）和90.9%（160/176）的患者实现了HIV-1 RNA水平<50拷贝/mL。在第48周，CD4计数中位数增加了139.5细胞/μL（120.5 - 158.5），CD4/CD8比值增加了0.2（0.1 - 0.3）（P < 0.001）。观察期间无患者因不良事件停药。
DTG + 3TC在晚期就诊患者中显示出高病毒学疗效和良好的耐受性。然而，该方案可能与血脂水平和体重增加有关，突出了定期监测的必要性。
