RT Journal Article
T1 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.
A1 Teira, Ramón
A1 Diaz-Cuervo, Helena
A1 Aragão, Filipa
A1 Castaño, Manuel
A1 Romero, Alberto
A1 Roca, Bernardino
A1 Montero, Marta
A1 Galindo, Maria José
A1 Muñoz-Sánchez, Maria Jose
A1 Espinosa, Nuria
A1 Peraire, Joaquim
A1 Martínez, Elisa
A1 de la Fuente, Belén
A1 Domingo, Pere
A1 Deig, Elisabeth
A1 Merino, María Dolores
A1 Geijo, Paloma
A1 Estrada, Vicente
A1 Sepúlveda, María Antonia
A1 García, Josefina
A1 Berenguer, Juan
A1 Currán, Adriá
K1 Adverse events
K1 Effectiveness
K1 HIV
K1 Time to discontinuation
K1 Triple therapy
K1 Two-drug combinations
K1 Virologic failure
AB 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). 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  Overall, 5047 3DR and 617 2DR patients were analyzed. Baseline characteristics differed between groups; 2DR patients were older, more treatment experienced, and more likely to be virologically suppressed at switch. Time to discontinuation due to TF was significantly shorter for 2DR (P = 0.002). The hazard ratio (HR) for discontinuation due to TF on 2DR vs 3DR was 2.33 (P = 0.003). No difference was observed for time to discontinuation (P = 0.908) or risk of discontinuation due to AEs (HR = 0.80; P = 0.488). Results were qualitatively similar in virologically suppressed patients, matched analysis, and for VF. In the real world, the risks of discontinuation due to TF and VF were more than two times higher in patients switching to DTG-based 2DR than INSTI-based 3DR, with no difference in discontinuation due to AEs.
SN 2193-8229
YR 2022
FD 2022-04-11
LK http://hdl.handle.net/10668/21552
UL http://hdl.handle.net/10668/21552
LA en
DS RISalud
RD Apr 7, 2025