PDF(Pubmed)
Abstract：
The continuous pharmacological advances in antiretroviral treatment (ART) and the increasing understanding of HIV drug resistance has led to a change in the paradigm of ART optimization in the setting of the viral suppression of treatment-experienced patients with the emerging evidence of the effectiveness and safety of dual therapies. The aim of this study is to determine the antiviral efficacy and safety of switching to Dolutegravir + Lamivudine in people living with HIV, and to analyze the rate of patients with virologic failure (VF). A total of 200 patients were included with a median age of 51 years, 189 cells/µL of nadir CD4+, 13 years on ART and four previous ART regimens. Among the 168 patients who completed a follow-up at 48 weeks, a total of five VFs occurred, resulting in a 2.98% (5/168) VF rate. The results of the intention-to-treat analysis were a VF rate of 2.54% (5/197), and the rate of patients/year with viral suppression was 98.3% (298/303) in the observed data analysis. We observed a significant improvement in mean CD4 lymphocytes, the CD4/CD8 ratio and lipid profiles. The optimization of ART to DTG plus 3TC is a cost-effective switch option for treatment-experienced HIV patients, and also improves their lipid profiles.
摘要：
抗逆转录病毒治疗（ART）的持续药理学进展和对HIV耐药性的日益理解导致了ART优化范式的变化，在治疗经验丰富的患者的病毒抑制环境中，有新的证据表明双重疗法的有效性和安全性。这项研究的目的是确定在艾滋病毒感染者中转换为Dolutegravir拉米夫定的抗病毒疗效和安全性，并分析病毒学失败（VF）患者的发生率。共纳入200名患者，中位年龄为51岁，189个细胞/微升的最低点CD4+，13年的ART和之前的四个ART方案。在48周完成随访的168例患者中，总共发生了五个VF，导致2.98%（5/168）的VF率。意向治疗分析结果为VF率为2.54%(5/197),在观察到的数据分析中，病毒抑制患者/年的比率为98.3％（298/303）。我们观察到平均CD4淋巴细胞显着改善，CD4/CD8比率和脂质分布。对于有治疗经验的HIV患者，将ART优化为DTG加3TC是一种具有成本效益的转换选择，并且还改善了它们的脂质分布。
