Shorter Time to Discontinuation Due to Treatment Failure in People Living with HIV Switched to Dolutegravir Plus Either Rilpivirine or Lamivudine Compared with Integrase Inhibitor-Based Triple Therapy in a Large Spanish Cohort

Introduction Standard therapy for HIV treatment has consisted of two nucleoside analogue reverse transcriptase inhibitors (NRTI) paired with a third agent. Use of two-drug regimens (2DR) has been considered for selected patients in part to avoid toxicities associated with the use of NRTIs. This stud...

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Published in:Infectious diseases and therapy 2022-06, Vol.11 (3), p.1177-1192
Main Authors: Teira, Ramón, Diaz-Cuervo, Helena, Aragão, Filipa, Castaño, Manuel, Romero, Alberto, Roca, Bernardino, Montero, Marta, Galindo, Maria José, Muñoz-Sánchez, Maria Jose, Espinosa, Nuria, Peraire, Joaquim, Martínez, Elisa, de la Fuente, Belén, Domingo, Pere, Deig, Elisabeth, Merino, María Dolores, Geijo, Paloma, Estrada, Vicente, Sepúlveda, María Antonia, García, Josefina, Berenguer, Juan, Currán, Adriá
Format: Article
Language:English
Subjects:
AIDS treatment
Antiretroviral drugs
Comparative analysis
Development and progression
DNA polymerases
Drug therapy
HIV
HIV (Viruses)
HIV patients
Human immunodeficiency virus
Infectious Diseases
Internal Medicine
Lamivudine
Medicine
Medicine & Public Health
Original Research
Rilpivirine
Sexually transmitted diseases
Side effects
STD
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Summary:Introduction Standard therapy for HIV treatment has consisted of two nucleoside analogue reverse transcriptase inhibitors (NRTI) paired with a third agent. Use of two-drug regimens (2DR) has been considered for selected patients in part to avoid toxicities associated with the use of NRTIs. This study aimed to compare the real-world outcomes of integrase inhibitor (INSTI)-based three-drug regimens (3DR) versus 2DR of dolutegravir (DTG) + rilpivirine (RPV) or DTG + lamivudine (3TC). Methods All patients in the Spanish VACH cohort switching to INSTI-based 3DR or a 2DR consisting of DTG + RPV or DTG + 3TC between May 2, 2016 and May 15, 2019 were included. Kaplan–Meier curves and Cox proportional hazard models were used to assess time to/risk of discontinuation due to treatment failure (TF) (defined as virologic failure [VF], immunologic failure, or disease progression) and adverse events (AEs). Three secondary analyses were performed: (1) in restricting the analysis to patients who were virologically suppressed (HIV RNA 
ISSN:2193-8229
2193-6382
DOI:10.1007/s40121-022-00630-y