Salvage therapy or simplification of salvage regimens with dolutegravir plus ritonavir-boosted darunavir dual therapy in highly cART-experienced su... - PubMed - NCBI

Salvage therapy or simplification of salvage regimens with dolutegravir plus ritonavir-boosted darunavir dual therapy in highly cART-experienced su... - PubMed - NCBI

Antivir Ther. 2016 Sep 23. doi: 10.3851/IMP3095. [Epub ahead of print]

Salvage therapy or simplification of salvage regimens with dolutegravir plus ritonavir-boosted darunavir dual therapy in highly cART-experienced subjects: an Italian cohort.

Capetti AF1, Orofino G, Sterrantino G, Cossu MV, Cenderello G, Cattelan AM, De Socio GV, Rusconi S, Riccardi N, Baldin GM, Cima S, Niero FP, Rizzardini G, Sasset L.

Author information

Abstract

BACKGROUND:

Dolutegravir plus darunavir provide high genetic barrier to HIV-1 resistance and fit for simple salvage regimens.

METHODS:

All HIV-1 infected subjects treated with dolutegravir plus boosted darunavir dual therapy between March 2011 and September 2015 were included in an observational cohort. Data were collected at baseline and at weeks 4, 12, 24 and 48.

RESULTS:

We enrolled 113 subjects. After week 24 one was lost at follow-up, one dropped out for grade 2 elevation of liver enzimes, one died from illicit drug abuse and one from cancer-related sepsis. The mean age was 51, females 26.5%, non-caucasians 9.7%. Twenty had never experienced failure. Ninety-nine had reverse-trascriptase (RT) mutations, 87 had protease inhibitor mutations, and 12 had integrase strand transfer inhibitor (INSTI) mutations.Viremic patients declined from baseline to week 24 from 43.4% to 6.2%, the remainder being due to high baseline viremia or adherence issues. The proportion of subjects with viraemia 1 - 49 copies/mL remained at 20.4% while those in whom no virus was detected (NVD) increased from 36.3% to 73.5% by week 24. All the 47 subjects who have a 48-week follow-up had < 50 copies/mL and 42 (89.4%) had NVD. Eighteen subjects had reduced sensitivity to darunavir (Stanford median score 15, range 15 - 40), but none rebounded, 6 having a 24-week and 7 a 48-week follow-up. The median variation in serum creatinine was -0,01 (range + 0.2 to - 0.21).

CONCLUSIONS:

This dual regimen provides a simple salvage regimen and proved safe and effective in this cohort.

PMID:

 

27661787

 

DOI:

 

10.3851/IMP3095

[PubMed - as supplied by publisher]

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