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Dolutegravir monotherapy as treatment de-escalation in HIV-infected adults with virological control: DoluMono cohort results.

TitleDolutegravir monotherapy as treatment de-escalation in HIV-infected adults with virological control: DoluMono cohort results.
Publication TypeJournal Article
Year of Publication2017
AuthorsOldenbuettel C, Wolf E, Ritter A, Noe S, Heldwein S, Pascucci R, Wiese C, Von Krosigk A, Jaegel-Guedes E, Jaeger H, Balogh A, Koegl C, Spinner CD
JournalAntivir Ther
Volume22
Issue2
Pagination169-172
Date Published2017
ISSN2040-2058
KeywordsAdult, Female, gamma-Glutamyltransferase, Heterocyclic Compounds, 3-Ring, HIV Infections, HIV Integrase Inhibitors, HIV-1, Humans, Male, Middle Aged, Retrospective Studies, RNA, Viral
Abstract

BACKGROUND: The potential toxicity of long-term antiretroviral therapy (ART) requires ongoing investigation of novel strategies for treatment of HIV-infected patients. Monotherapy with the integrase inhibitor (INSTI) dolutegravir (DTG) may offer a favourable safety profile. Additionally, DTG has a high barrier of resistance, crucial for successful maintenance of virological control. However, published data is sparse.

METHODS: Retrospective, single-centre cohort study. We enrolled patients on suppressive ART who were switched to DTG monotherapy in routine clinical practice and fulfilled the following inclusion criteria: HIV RNA level

RESULTS: We identified 31 patients with 24-weeks of follow-up data. Previous ART included a non-nucleoside reverse transcriptase inhibitor, a boosted protease inhibitor or an INSTI in 32%, 6% and 61% of patients, respectively. At week 24, HIV RNA remained

CONCLUSIONS: De-escalating to DTG monotherapy in selected patients might be a safe and feasible option. However, in one case evolution of INSTI resistance was observed. Further studies should assess particular risk factors for DTG monotherapy failure. In the meanwhile, caution is warranted.

DOI10.3851/IMP3082
Alternate JournalAntivir. Ther. (Lond.)
PubMed ID27588613