Dolutegravir as maintenance monotherapy: first experiences in HIV-1 patients

The Journal of Antimicrobial Chemotherapy
Casper RokxBart J A Rijnders

Abstract

Dolutegravir is recommended as part of combination ART (cART) for HIV-1-infected patients. Toxicities, drug interactions and costs related to cART still warrant the search for improved treatment options. Dolutegravir's high resistance barrier might make it suitable as antiretroviral maintenance monotherapy. The feasibility of this strategy is currently unknown. This is a prospective case series on five consecutive HIV-1-infected patients on cART without previous virological failure who switched to dolutegravir monotherapy. All were HIV-RNA suppressed <50 copies/mL and had contraindications to current and alternative combinations of antiretroviral drugs. HIV-RNA was measured at baseline, week 4, week 8, week 12 and every 6 weeks thereafter. Patients would be switched back to their original cART upon confirmed HIV-RNA >50 copies/mL. The five patients had been HIV-RNA suppressed <50 copies/mL for ≥1.5 years prior to the initiation of dolutegravir monotherapy. All were on NNRTI-containing regimens at the switch. HIV-RNA remained <50 copies/mL at all timepoints in four patients. One patient, with end-stage renal disease and on calcium supplements, had a pre-cART HIV-RNA of 625 000 copies/mL with a CD4 nadir of 120 cells/mm(3) and ha...Continue Reading

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Citations

May 15, 2016·The Journal of Antimicrobial Chemotherapy·José Moreira
Sep 13, 2016·Expert Opinion on Pharmacotherapy·Laura Comi, Franco Maggiolo
Jun 18, 2017·Expert Opinion on Drug Safety·Vicente SorianoPablo Labarga
Jun 24, 2017·The Journal of Antimicrobial Chemotherapy·Alonso HerediaMark A Wainberg
Apr 5, 2018·The Journal of Infectious Diseases·Ingeborg E A WijtingJeroen J A van Kampen
Jan 11, 2018·Nature Communications·Ameya R KirtaneGiovanni Traverso
Mar 13, 2019·Pharmacotherapy·Kristina M BrooksDavid B Cluck
Jan 3, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Laurent HocquelouxUNKNOWN MONCAY study group
Jul 8, 2019·The Journal of Antimicrobial Chemotherapy·Soo-Yon RheeRobert W Shafer
Jan 13, 2018·International Journal of STD & AIDS·Emanuela LattuadaSandro Vento
Nov 7, 2017·Pharmacotherapy·Christopher McCoyUNKNOWN Society of Infectious Diseases Pharmacists

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