Switch to dolutegravir and unboosted atazanavir in HIV-1 infected patients with undetectable viral load and long exposure to antiretroviral therapy

&NA; We evaluated the efficacy and safety of a two-drug regimen including dolutegravir (DTG) and unboosted atazanavir (uATV) in 151 HIV-1 infected patients with HIV-RNA of more than 50 copies/ml. During a median follow-up of 62 (42–97) weeks, two virological failures (1%) and 13 treatment discontinuations (9%) occurred; the 48-week probability of virological failure was 0.8% (95% confidence interval 0.2–5.6%). Switch to DTG + uATV may represent a boosting and transcriptase reverse inhibitors sparing otion in individuals with long exposure to antiretroviral therapy and risk of cardiovascular disease.

[1]  A. Lazzarin,et al.  Brief Report: Hyperbilirubinemia Is Associated With a Decreased Risk of Carotid Atherosclerosis in HIV-Infected Patients on Virological Suppression , 2018, Journal of acquired immune deficiency syndromes.

[2]  Roger Paredes,et al.  Dolutegravir-based maintenance monotherapy versus dual therapy with lamivudine: a planned 24 week analysis of the DOLAM randomized clinical trial , 2018, The Journal of antimicrobial chemotherapy.

[3]  R. Maserati,et al.  Impact of the M184V Resistance Mutation on Virological Efficacy and Durability of Lamivudine-Based Dual Antiretroviral Regimens as Maintenance Therapy in Individuals With Suppressed HIV-1 RNA: A Cohort Study , 2018, Open forum infectious diseases.

[4]  C. Hung,et al.  Efficacy, safety, and tolerability of dolutegravir-rilpivirine for the maintenance of virological suppression in adults with HIV-1: phase 3, randomised, non-inferiority SWORD-1 and SWORD-2 studies , 2018, The Lancet.

[5]  M. Foisy,et al.  Dolutegravir Dual Therapy as Maintenance Treatment in HIV-Infected Patients: A Review , 2018, The Annals of pharmacotherapy.

[6]  C. Charpentier,et al.  HIV-1 DNA ultra-deep sequencing analysis at initiation of the dual therapy dolutegravir + lamivudine in the maintenance DOLULAM pilot study , 2017, The Journal of antimicrobial chemotherapy.

[7]  C. Katlama,et al.  Efficacy and safety of dolutegravir and rilpivirine dual therapy as a simplification strategy: a cohort study , 2017, HIV medicine.

[8]  C. Mussini,et al.  Lamivudine/dolutegravir dual therapy in HIV-infected, virologically suppressed patients , 2017, BMC Infectious Diseases.

[9]  G. Barbarini,et al.  Switch to Dolutegravir plus Rilpivirine Dual Therapy in cART-Experienced Subjects: An Observational Cohort , 2016, PloS one.

[10]  K. Brinkman,et al.  Intolerance of dolutegravir-containing combination antiretroviral therapy regimens in real-life clinical practice , 2016, AIDS.

[11]  G. Cenderello,et al.  Salvage Therapy or Simplification of Salvage Regimens with Dolutegravir plus Ritonavir-Boosted Darunavir Dual Therapy in Highly cART-Experienced Subjects: An Italian Cohort , 2016, Antiviral therapy.

[12]  N. Ciccarelli,et al.  Virological control and metabolic improvement in HIV-infected, virologically suppressed patients switching to lamivudine/dolutegravir dual therapy. , 2016, The Journal of antimicrobial chemotherapy.

[13]  J. van Lunzen,et al.  Brief Report: Switch to Ritonavir-Boosted Atazanavir Plus Raltegravir in Virologically Suppressed Patients With HIV-1 Infection: A Randomized Pilot Study , 2016, Journal of acquired immune deficiency syndromes.

[14]  L. Hocqueloux,et al.  Dolutegravir-based monotherapy or dual therapy maintains a high proportion of viral suppression even in highly experienced HIV-1-infected patients , 2015, The Journal of antimicrobial chemotherapy.

[15]  D. Wohl,et al.  The ASSURE study: HIV‐1 suppression is maintained with bone and renal biomarker improvement 48 weeks after ritonavir discontinuation and randomized switch to abacavir/lamivudine + atazanavir† , 2015, HIV medicine.

[16]  B. Conway,et al.  A meta‐analysis of the efficacy and safety of unboosted atazanavir compared with ritonavir‐boosted protease inhibitor maintenance therapy in HIV‐infected adults with established virological suppression after induction , 2014, HIV medicine.

[17]  O. Kirk,et al.  Atazanavir is not associated with an increased risk of cardio or cerebrovascular disease events , 2013, AIDS.

[18]  D. Ward,et al.  ARIES 144 Week Results: Durable Virologic Suppression in HIV-Infected Patients Simplified to Unboosted Atazanavir/Abacavir/Lamivudine , 2012, HIV clinical trials.

[19]  E. Clementi,et al.  Switching to unboosted atazanavir reduces bilirubin and triglycerides without compromising treatment efficacy in UGT1A1*28 polymorphism carriers. , 2012, The Journal of antimicrobial chemotherapy.

[20]  S. Piscitelli,et al.  Effect of atazanavir and atazanavir/ritonavir on the pharmacokinetics of the next-generation HIV integrase inhibitor, S/GSK1349572. , 2011, British journal of clinical pharmacology.

[21]  D. Cooper,et al.  Raltegravir and unboosted atazanavir dual therapy in virologically suppressed antiretroviral treatment-experienced HIV patients , 2010, Antiviral therapy.