Abstract：
Use of doravirine (DOR), a new nonnucleoside reverse-transcriptase inhibitors recently approved for HIV treatment, is still unclear in clinical practice and real-life data are scarce. We retrospectively investigated the rationale for switching people with HIV to DOR-containing/-based regimens in a real-life cohort. Among 132 patients (68.9% males, median age 56 years), the main reasons to start DOR were prevention of toxicities (39.4%) and dyslipidemia (18.2%). DOR was combined with integrase inhibitors in 40.9% cases, and in 25.7% of patients, DOR was prescribed without availability of a genotypic resistance test. Twenty-four weeks after the switch to DOR-containing/-based regimens, no significant changes in CD4+ T-cell count, CD4/CD8 ratio, detectable HIV-RNA, serum creatinine levels, and body weight were detected. By contrast, a significant reduction in lipids (both cholesterol and triglycerides) was observed in 52 patients for whom a follow-up assessment was available (P = .008 and .01, respectively). Our data confirmed that switching to DOR-containing/-based regimens may have a favorable impact on lipid profile and a neutral impact on weight gain. However, more data are needed to support its use in patients who do not have a genotypic test available or have an extensive nonnucleoside reverse-transcriptase inhibitors-associated resistance, as well as its use in a dual regimen, especially in combination with second-generation integrase inhibitors.
摘要：
使用多拉韦林（DOR），一种新的非核苷类逆转录酶抑制剂最近被批准用于HIV治疗，在临床实践中仍不清楚，现实生活中的数据很少。我们回顾性调查了在现实生活队列中将HIV感染者转换为含DOR/基于DOR的治疗方案的理由。132名患者（68.9%为男性，中位年龄56岁)，开始DOR的主要原因是预防毒性(39.4%)和血脂异常(18.2%).DOR联合整合酶抑制剂40.9%,在25.7%的患者中，DOR是在没有基因型抗性测试的情况下开出的。改用含DOR/基于DOR的方案后24周，CD4+T细胞计数无显著变化,CD4/CD8比值,可检测的HIV-RNA，血清肌酐水平，检测到体重。相比之下,在有随访评估的52例患者中观察到血脂(胆固醇和甘油三酯)显著降低(分别为P=.008和.01).我们的数据证实，转换为含DOR/基于DOR的方案可能对血脂谱产生有利影响，并对体重增加产生中性影响。然而,需要更多的数据来支持其在没有基因型测试或有广泛的非核苷类逆转录酶抑制剂相关耐药性的患者中的使用，以及它在双重方案中的使用，特别是与第二代整合酶抑制剂联合使用。
