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Open Access
  • © Arturo Ciccullo
  • , et al.
  • 2022

Short Communication: Efficacy and Safety of Dolutegravir Plus Lamivudine as a First-Line Regimen in Clinical Practice

  • Arturo Ciccullo 1,2
  • Gianmaria Baldin 3,4
  • Alex Dusina 3,4
  • Maria Vittoria Cossu 5,6
  • Francesca Lombardi 7
  • Alberto Borghetti 8
  • Amedeo Capetti 9
  • Simona Di Giambenedetto 8
  • 1 - Dipartimento di Sicurezza e Bioetica Sezione Malattie Infettive
  • 2 - Università Cattolica del Sacro Cuore - Roma Italy
  • 3 - Fondazione Policlinico Universitario A. Gemelli IRCCS
  • 4 - UOC Malattie Infettive - Roma Italy
  • 5 - Division of Infectious Diseases Department of Infectious Diseases
  • 6 - Luigi Sacco University Hospital - Milano Italy
  • 7 - Dipartimento di Sicurezza e Bioetica Sezione Malattie Infettive - Università Cattolica del Sacro Cuore - Roma Italy
  • 8 - Fondazione Policlinico Universitario A. Gemelli IRCCS - UOC Malattie Infettive - Roma Italy
  • 9 - Division of Infectious Diseases - Department of Infectious Diseases - Luigi Sacco University Hospital - Milano Italy

Abstract

The GEMINI trials have showed that the two drugs regimen of dolutegravir+lamivudine (DTG +3TC) was noninferior to a three-drug regimen as a first line regimen for treatment-naive people living with HIV. The aim of our study was to confirm, in a real-life setting, the efficacy of this regimen. We conducted a retrospective, observational study enrolling treatment-naive patients starting a first-line regimen with lamivudine plus dolutegravir. We evaluated the virological efficacy and the immunological and metabolic profiles. Changes from baseline were evaluated through linear-mixed models for repeated measures. Linear regression analyses were performed to explore variables associated to significant changes in laboratory parameters. We analyzed a total of 20 patients: 15 (75%) were men with a median age of 34.5 years. During a cumulative time of 15.4 patients years of follow up (PYFU), we did not observe any adverse event or treatment discontinuation and all patients achieved virological suppression in the first 6 months from treatment initiation. Increase in CD4+ cells was significant at both week 24 (p = .003) and week 48 (p = .007) of follow-up. Moreover, CD4/CD8 ratio also significantly improved [median increase of +0.22 (p = .028) after 48 weeks of follow-up]. As to metabolic parameters, we observed no significant changes in total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. In a subgroup of 11 patients, we further investigate HIV-1 DNA variations. Our results are in line with the findings of the GEMINI trials, confirming the efficacy and safety of DTG +3TC in treatment-naive patients.


 


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