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Effect of dolutegravir in combination with Nucleoside Reverse Transcriptase Inhibitors (NRTIs) on people living with HIV who have pre-existing NRTI mutations
- Source :
- International Journal of Antimicrobial Agents. 51:733-738
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Until the introduction of dolutegravir (DTG), people living with HIV (PLWH) who have developed nucleoside reverse transcriptase inhibitor (NRTI) mutations have had few other treatment options outside of regimens based on ritonavir-boosted protease inhibitors (PI/r). Here we report treatment results among PLWH in Sweden with pre-existing NRTI mutations on antiretroviral treatment (ART) with DTG and one to two NRTIs. All PLWH on ART with DTG and one to two NRTIs with pre-existing NRTI mutations were retrospectively identified from the National InfCare HIV database. As controls, PLWH on PI/r and one to two NRTIs, matched according to Genotypic Susceptibility Score and observation time, were included. Data were collected as long as the study population was on treatment with DTG; controls were monitored for the same interval. Outcome was classified as either treatment success or failure. In total, 244 participants (122 individuals treated with DTG and 122 individuals treated with PI/r) were included. Median observation time was 78 weeks (interquartile range 50-98 weeks) for participants on DTG and 75 weeks (50-101 weeks) for individuals on PI/r. Viral failure was detected in four individuals treated with DTG and three individuals treated with PI/r, resulting in similar success rates of 96.7% and 97.5%, respectively. No new mutations were found among participants with treatment failure. DTG in combination with one to two NRTIs was as efficient as PI/r in individuals with pre-existing NRTI mutations in this setting. It may be considered an alternative to PI/r-based ART even in the presence of NRTI resistance.
- Subjects :
- Male
0301 basic medicine
Microbiology (medical)
Oncology
medicine.medical_specialty
Anti-HIV Agents
Pyridones
030106 microbiology
Human immunodeficiency virus (HIV)
HIV Infections
medicine.disease_cause
Piperazines
Nucleoside Reverse Transcriptase Inhibitor
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Pharmacotherapy
immune system diseases
Interquartile range
Internal medicine
Drug Resistance, Viral
Oxazines
Genotype
medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
Aged
Retrospective Studies
Aged, 80 and over
Antiinfective agent
Ritonavir
business.industry
virus diseases
General Medicine
Middle Aged
HIV Reverse Transcriptase
Treatment Outcome
Infectious Diseases
chemistry
Mutation
Dolutegravir
HIV-1
Reverse Transcriptase Inhibitors
Population study
Drug Therapy, Combination
Female
business
Heterocyclic Compounds, 3-Ring
Subjects
Details
- ISSN :
- 09248579
- Volume :
- 51
- Database :
- OpenAIRE
- Journal :
- International Journal of Antimicrobial Agents
- Accession number :
- edsair.doi.dedup.....9c433d1a272c4738dfbacf07c233a680