Dolutegravir/Lamivudine Results in HIV Suppression in Small Treatment-Naive Cohort

Virologic suppression was achieved in treatment-naive patients with HIV after dolutegravir/lamivudine initiation, including those with high baseline viral loads.

A 2-drug antiretroviral therapy (ART) regimen of dolutegravir/lamivudine (DTG/3TC) resulted in sustained virologic suppression in patients with HIV infection, regardless of viral load at treatment initiation. These study results were presented at IDWeek 2022, held from October 19 to 23, 2022, in Washington, DC.

Researchers conducted a retrospective study at 24 US sites to evaluate treatment outcomes associated with DTG-based ART regimens among patients with HIV infection. Eligible patients (N=469) were adults who initiated ART with either a single tablet of DTG/3TC or DTG/rilpivirine before September 2020; the minimum follow-up period was 6 months. The researchers assessed clinical characteristics and treatment outcomes among treatment-naive patients with baseline HIV viral loads of at least 100,000 copies/mL who received DTG/3TC.

There were 318 patients included in the analysis who received DTG/3TC, of whom 58 were both naive to treatment and had available viral load data at baseline. Of these patients, 9 had baseline viral loads between 100,000 and 250,000 copies/mL (subcohort 1) and 7 had viral loads greater than 250,000 copies/mL (subcohort 2).

Among patients in subcohorts 1 and 2, the median age was 34.0 (range, 24-55) and 33.0 (range, 25-53) years, 77.8% and 100% were men, 44.4% and 28.6% were Black, the median CD4 count at treatment initiation was 312 (IQR, 43.5-584) and 114 (IQR, 29-481) cells/mm3, respectively.

These real world results reflect data from clinical trials, demonstrating DTG/3TC is effective and well tolerated in the real world.

Virologic suppression (HIV viral load <50 copies/mL) was achieved by the majority of patients in subcohorts 1 (88.9%) and 2 (85.7%) after initiation of DTG/3TC, with a median time to suppression of 11.2 (IQR, 6.2-30.0) and 20.6 (IQR, 10.5-32.4) weeks, respectively. Of note, 1 patient in subcohort 2 experienced virologic rebound but continued treatment with DTG/3TC.

These results may have limited generalizability due to the small size of patients included in the subcohorts.

“These real world results reflect data from clinical trials, demonstrating DTG/3TC is effective and well tolerated in the real world,” the researchers concluded.

Disclosure: Some authors declared affiliations with the pharmaceutical industry. Please see the reference for a full list of disclosures.

References:

Metzner A, Benson P, Donovan C, et al. Real world treatment experience of single tablet dolutegravir/lamivudine in those naïve to treatment with baseline viral loads ≥ 100,000 copies/mL in the US. Presented at: IDWeek 2022; October 19-23; Washington, DC. Poster 1278.