Dolutegravir-based regimen for maintenance of viral suppression in people living with HIV: 48-week results in real life setting.

Abstract

To evaluate the efficacy, safety and tolerability of switching to a dolutegravir (DTG)-based regimen in a cohort of virological suppressed HIV-infected patients. The dynamics of total HIV-DNA and levels of high-sensitivity c-reactive protein (hsCRP), interleukin-6 (IL-6), soluble-CD14 (sCD14) and D-Dimer were also analyzed. Ninety-six individuals who switched to a DTG-containing regimen were followed up for 48 weeks. HIV-RNA, CD4+ T cell count, weight and levels of laboratory parameters were recorded at baseline (W0), after 24 (W24) and 48 (W48) weeks of treatment for all study participants. In a subgroup of patients, HIV-DNA levels were evaluated at W0, W2 and W24 and inflammation/coagulation markers were analyzed at W0 and W24. Ninety-three out of 96 patients maintained virological suppression, including patients who switched to dual-therapy from triple-drug combination. Eighteen out of 96 patients had residual viremia at baseline, of which 13 reached the maximal viral suppression at W48. Serum creatinine levels showed a significant increase at weeks 24 and 48. A progressive reduction of total cholesterol was observed from week 24 and up to week 48. No variation in Body Mass Index was detected. HIV-DNA, inflammation and coagulation marker levels did not significantly change during follow-up. Switching to a DTG-based regimen may be a key option for achieving and maintaining maximal virological suppression, even in patients showing residual viremia at baseline. Furthermore, the improvement in blood lipid profile and the overall tolerability observed in this study strongly support the use of these regimens in the ageing HIV population.