Effectiveness and tolerability of dolutegravir/lamivudine for the treatment of HIV-1 infection in clinical practice
Inés Suárez‐García, Belén Alejos, Víctoria Hernando, Laura Viñuela, Mar Vera García, David Rial‐Crestelo, Marı́a Jesús Pérez-Elı́as, Helena Iglesias, Joaquim Peraire, Juan Tiraboschi, Asunción Díaz, Santiago Moreno, Inmaculada Jarrín, Santiago Moreno, Inmaculada Jarrín, David Dalmau, Marta Navarro, Maria Gonzalez, Féderico García, Eva Poveda, José Antonio Iribarren, Félix Gutiérrez, Rafael Rubio, Francesc Vidal, Juan Berenguer, Juan González, María Ángeles Muñoz‐Fernández, Inmaculada Jarrín, Cristina Moreno, Marta Rava, Rebeca Izquierdo, Jorge del Romero Raposo, Cristina Marco, Julián Puente, María Ángeles Muñoz‐Fernández, Elba Mauleón, Roxana Juárez, Joaquín Portilla, Irene Portilla, Esperanza Merino, Gema García, Iván Agea, José Sánchez–Payá, Juan Carlos Rodrı́guez, Livia Giner, Sergio Reus, Vicente Boix, Diego Torrús, Verónica Pérez, Julia Portilla, María Remedios Alemán Valls, Jehovana Hernández, Ana López Lirola, Dácil García, Felícitas Díaz-Flores, M. Mar Alonso, Ricardo Pelazas, Víctor Asensi, M Eugenia Rivas, Tomás Suárez‐Zarracina, Eulalia Valle-Garay, Javier Arias‐Díaz, Federico Pulido, Rafael Rubio, Otilia Bisbal, M. Asunción Hernando, David Rial, María Lagarde, Octavio Arce, Adriana Pinto, Laura Muñoz Bermejo, Mireia Santacreu, Roser Navarro, Candela Gonzalez, José Antonio Iribarren, María José Aramburu, Xabier Camino, Miguel Ángel von Wichmann, Miguel Ángel Goenaga, Ma Jesús Bustinduy, Harkaitz Azkune, Maialen Ibarguren, Xabier Kortajarena, Ignacio Álvarez-Rodriguez, Leire Gil, Lourdes Martínez, Félix Gutiérrez, Mar Masiá, Catalina Robledano, Sergio Padilla, Javier García Abellán, Paula Mascarell, Araceli Adsuar, Rafael J. Pascual, Mar Carvajal, Marta Fernández, José Alberto García, Ángela Botella, Alba de la Rica, Carolina Ding
Abstract
OBJECTIVES: To assess the effectiveness and tolerability of dolutegravir (DTG)/lamivudine (3TC) among treatment-naive and virologically suppressed treatment-experienced individuals in the multicentre cohort of the Spanish HIV/AIDS Research Network (CoRIS) during the years 2018-2021. METHODS: We used multivariable regression models to compare viral suppression (VS) [HIV RNA viral load (VL) <50 copies/mL] and the change in CD4 cell counts at 24 and 48 (±12) weeks after initiation with dolutegravir/lamivudine or other first-line ART regimens. RESULTS: We included 2160 treatment-naive subjects, among whom 401 (18.6%) started with dolutegravir/lamivudine. The remaining subjects started bictegravir (BIC)/emtricitabine (FTC)/tenofovir alafenamide (TAF) (n = 949, 43.9%), DTG + FTC/tenofovir disoproxil fumarate (TDF) (n = 282, 13.1%), DTG/3TC/abacavir (ABC) (n = 255, 11.8%), darunavir (DRV)/cobicistat(COBI)/FTC/TAF (n = 147, 6.8%) and elvitegravir (EVG)/COBI/FTC/TAF (n = 126, 5.8%). At 24 and 48 weeks after starting dolutegravir/lamivudine, 91.4% and 93.8% of the subjects, respectively, achieved VS. The probability of achieving VS with dolutegravir/lamivudine was not significantly different compared with any other regimen at 24 or 48 weeks, with the exception of a lower chance of achieving VS at 24 weeks for DRV/COBI/FTC/TAF (adjusted OR: 0.47; 95% CI: 0.30-0.74) compared with dolutegravir/lamivudine.For the analysis of treatment-experienced virally suppressed subjects we included 1456 individuals who switched to dolutegravir/lamivudine, among whom 97.4% and 95.5% maintained VS at 24 and 48 weeks, respectively. During the first 48 weeks after dolutegravir/lamivudine initiation, 1.0% of treatment-naive and 1.5% of treatment-experienced subjects discontinued dolutegravir/lamivudine due to an adverse event. CONCLUSIONS: In this large multicentre cohort, effectiveness and tolerability of dolutegravir/lamivudine were high among treatment-naive and treatment-experienced subjects.