scholarly journals Evaluation of the Efficacy and Tolerability of Dolutegravir Plus Lamivudine as a Switch Strategy in Treatment-experienced HIV-infected Patients

2020 ◽  
Author(s):  
Wei Hua ◽  
Sen Wang ◽  
Bin Su ◽  
Wenxin Wang ◽  
An Liu ◽  
...  
Keyword(s):  
Safety Data ◽  
Dual Therapy ◽  
Drug Regimen ◽  
Clinical Findings ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Prior Art ◽  
Cd4 Cell ◽  
Switch Strategy

Abstract Background: Dual therapy containing dolutegravir (DTG) plus lamivudine (3TC) is a reasonable alternative antiretroviral therapy (ART) option in treatment-experienced patients, which could prevent long-term toxicity and reduce treatment cost. But so far, the effectiveness as safety data of this two-drug regimen is still limited. Methods: This observational study included treatment-experienced HIV-infected patients who switched to a dual regimen containing DTG (50mg/QD) plus 3TC (300mg/QD). Efficacy (HIV RNA <50 copies/mL), safety, and metabolic changes based on laboratory and clinical findings at 48 weeks were analyzed.Results: A total of 33 patients were included, who switched for the following reasons: treatment failure in 5 /33patients (15.2%), simplification in 10 patients (30.3%), and drug toxicity in 18 patients (54.5%). The patients were treated with ART for a median of 2.1 years (interquartile range = 1.0-4.2) before drug switching, and 28/33(84.8%) patients were virologically suppressed at baseline. After switching to DTG plus 3TC, all 33 patients (100%) showed HIV RNA <50 copies/mL after 48 weeks, and the CD4+ cell count was significantly increased (+82 cell/mm3, p=0.0071). We observed a significant increase in LDL-C (+0.77mg/dL, p<0.0001) after switch, however, triglycerides (-0.6mg/dL, p=0.0179) and cholesterol/HDL-C ratio (-0.327, p=0.0366) were found significantly decreased. A significant decrease in eGFR was also observed (-17.8 ml/min, p=0.0047). No patient discontinued due to adverse events.Conclusions: The use of dual therapy containing DTG and 3TC is effective and well-tolerated in treatment-experienced patients under any prior ART, without significant adverse drug reaction.

scholarly journals Impact of the M184V Resistance Mutation on Virological Efficacy and Durability of Lamivudine-Based Dual Antiretroviral Regimens as Maintenance Therapy in Individuals With Suppressed HIV-1 RNA: A Cohort Study

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Roberta Gagliardini ◽  
Arturo Ciccullo ◽  
Alberto Borghetti ◽  
Franco Maggiolo ◽  
Dario Bartolozzi ◽  
...  
Keyword(s):  
Resistance Mutation ◽  
Dual Therapy ◽  
Virologic Suppression ◽  
Lamivudine Resistance ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
History Of ◽  
Cd4 Cell ◽  
Virological Efficacy ◽  
Selection Of

Abstract Background Dual therapy (DT) with boosted protease inhibitors (bPIs) plus lamivudine has been shown to be superior to bPI monotherapy in virologically suppressed patients despite previous selection of the lamivudine resistance M184V mutation. We compared the virological efficacy of lamivudine-based DT in patients with and without a history of M184V detection. Methods We retrospectively analyzed patients with HIV-RNA ≤50 copies/mL switching to DT with at least 1 previous resistance genotype in the ARCA database. Time to virological failure (VF; HIV-RNA ≥200 copies/mL or 2 consecutive HIV-RNA &gt;50 copies/mL) and to treatment discontinuation (TD) was analyzed by survival analysis. Results Four hundred thirty-six patients switching to lamivudine plus bPIs (70%) or integrase inhibitors (30%) were included. Patients with M184V (n = 87) were older, had lower nadir CD4+ cell count, longer duration of antiretroviral therapy and of virologic suppression, and higher rate of hepatitis C virus infection compared with patients without M184V. The 3-year probability of remaining free from VF was 91.9% (95% confidence interval [CI], 86.6–97.2) without M184V and 87.8% (95% CI, 78.4–97.2) with M184V (P = .323). The time to TD did not differ between groups. Multivariate analysis adjusting for baseline variables differing between groups also did not detect M184V as being associated with VF or TD; however, the 3-year probability of remaining free of viral blips (isolated HIV-RNA 51–199 copies/mL) was 79.8% (95% CI, 67.8%–91.8%) with M184V vs 90.1% (95% CI, 84.0%–96.2%) without M184V (P = .016). Conclusions Previous selection of M184V did not increase the risk of VF or TD with lamivudine-based DT but was associated with a higher probability of viral blips.

Long-term statin use does not act on the temporal trend of CD4 cell count in patients on virologically effective HAART

AIDS ◽  
2006 ◽  
Vol 20 (3) ◽  
pp. 455-457 ◽  
Author(s):  
Roberto Manfredi ◽  
Leonardo Calza ◽  
Francesco Chiodo
Keyword(s):  
Cell Count ◽  
Temporal Trend ◽  
Cd4 Cell Count ◽  
Cd4 Cell ◽  
Statin Use

HIV RNA and CD4 cell count response to protease inhibitor therapy in an urban AIDS clinic: response to both initial and salvage therapy

AIDS ◽  
1999 ◽  
Vol 13 (6) ◽  
pp. F35-F43 ◽  
Author(s):  
Steven G. Deeks ◽  
Frederick M. Hecht ◽  
Melinda Swanson ◽  
Tarek Elbeik ◽  
Richard Loftus ◽  
...  
Keyword(s):  
Protease Inhibitor ◽  
Cell Count ◽  
Salvage Therapy ◽  
Inhibitor Therapy ◽  
Protease Inhibitor Therapy ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Count Response ◽  
Cd4 Cell

scholarly journals Immunological markers after long-term treatment interruption in chronically HIV-1 infected patients with CD4 cell count above 400 × 106 cells/l

AIDS ◽  
2005 ◽  
Vol 19 (1) ◽  
pp. 53-61 ◽  
Author(s):  
Rodolphe Thiébaut ◽  
Isabelle Pellegrin ◽  
Geneviève Chêne ◽  
Jean François Viallard ◽  
Hervé Fleury ◽  
...  
Keyword(s):  
Cell Count ◽  
Treatment Interruption ◽  
Term Treatment ◽  
Cd4 Cell Count ◽  
Immunological Markers ◽  
Long Term Treatment ◽  
Cd4 Cell ◽  
Hiv 1

Initiation of highly active antiretroviral therapy in advanced AIDS with CD4 < 50 cells/mm3 in a resource-limited setting: efficacy and tolerability

2005 ◽  
Vol 16 (3) ◽  
pp. 243-246 ◽  
Author(s):  
Somnuek Sungkanuparph ◽  
Sasisopin Kiertiburanakul ◽  
Weerawat Manosuthi ◽  
Wiphawee Kiatatchasai ◽  
Asda Vibhagool
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Count ◽  
Highly Active Antiretroviral Therapy ◽  
Adverse Drug Events ◽  
Opportunistic Infections ◽  
Transcriptase Inhibitor ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Highly Active ◽  
Cd4 Cell

In developing countries, patients often present late with advanced AIDS and a very low CD4 cell count. A retrospective cohort study was conducted in HIV-infected patients who had been initiated into highly active antiretroviral therapy (HAART) with CD4 cell count <50 cells/mm3. There were 159 patients of mean age 36.6 years and 60.4% had previous major opportunistic infections. Mean CD4 was 22 cells/mm3 and 80% had HIV RNA>100,000 copies/mL. The majority of HAART regimens is non-nucleoside reverse transcriptase inhibitor-based (81.8%). In as-treated analysis, 50, 71.2, 79.7, 79.4, and 80.1% of patients achieved undetectable HIV RNA (<50 copies/mL) at 12, 24, 36, 48, and 60 weeks, respectively. The corresponding mean CD4 counts were 95, 125, 166, 201, and 225 cells/mm3. Twenty two patients (13.8%) had adverse drug events and half of these had to discontinue HAART. Initiation of HAART in advanced AIDS with CD4 cell count <50 cells/mm3 is effective, safe, and well tolerated and should not be delayed.

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