A real-world study of treatment-experienced human immunodeficiency virus/acquired immunodeficiency syndrome patients switching to single-tablets regiments Dolutegravir/Lamivudine

ZHANG Xue; LI Chaofeng; YANG Xuan; ZHANG Xiaohua; ZHAO Shuxian; WEI Qian; QI Yaqiong; GUO Liying; ZHAO Qingxia

doi:10.3969/j.issn.1007-8134.2024.03.002

Abstract：Objective To evaluate the efficacy and safety of converting HIV/AIDS patients with viral suppression to single-tablet regiments dolutegravir/lamivudine (DTG/3TC) in the real world. Methods From June 1,2021 to June 1,2022,HIV/AIDS patients with long-term follow-up in the outpatient department of our hospital,who were effectively viral suppressed and converted to DTG/3TC during the study period were enrolled. The results of T lymphocyte subsets,HIV RNA,blood lipid,renal function and other indicators were collected before and during the conversion,and the occurrence of adverse events was recorded. Results This study included 79 patients with conversion treatment,which is given priority to with middle-aged men,30.4％ of patients with non-AIDS-defining-diseases. Top 3 reasons for conversion were:to simplify the regimen and improve the tolerability,side effects of medications,complicated with non-AIDS-defining diseases. Forty-eight weeks after conversion therapy,the sustained viral suppression rate was 100％ in 79 patients,and there was no significant differences in CD4+T lymphocyte count compared to baseline (P>0.05). Following 48 weeks of conversion therapy high-density lipoprotein-cholesterol,serum creatinine,blood glucose,body weight increased,estimated glomerular filtration rate and urine microalbumin decreased,and the differences were statistically significant (P<0.05). Five patients were converted to DTG/3TC because of dyslipidemia,total cholesterol decreased significantly after 48 weeks of conversion therapy (P<0.05). Thirteen patients were converted to DTG/3TC due to nephrotoxicity,and there were no significant differences in serum creatinine,estimated glomerular filtration rate,urinary microalbumin after 48 weeks of conversion therapy (P>0.05). Conclusion Conversion to DTG/3TC can achieve sustained viral suppression in patients who have achieved virological suppression,with good safety and tolerance,especially for complex patients with non-AIDS-defining-diseases,nephrotoxicity and dyslipidemia,which is one of the best optimized treatment options.