title: [Efficacy of dolutegravir in treatment-experienced patients: the SAILING and VIKING trials].
abstract: Dolutegravir is an HIV integrase inhibitor with a high genetic barrier to resistance and is active against raltegravir- and/or elvitegravir-resistant strains. The clinical development of dolutegravir for HIV infection rescue therapy is based on 3 clinical trials. In the SAILING trial, dolutegravir (5 mg once daily) in combination with 2 other antiretroviral agents was well tolerated and showed greater virological effect than raltegravir (400 mg twice daily) in the treatment of integrase inhibitor-naïve adults with virological failure infected with HIV strains with at least two-class drug resistance. The VIKING studies were designed to evaluate the efficacy of dolutegravir as rescue therapy in treatment-experienced patients infected with HIV strains with resistance mutations to raltegravir and/or elvitegravir. VIKING-1-2 was a dose-ranging phase IIb trial. VIKING-3 was a phase III trial in which dolutegravir (50 mg twice daily) formed part of an optimized regimen and proved safe and effective in this difficult-to-treat group of patients. Dolutegravir is the integrase inhibitor of choice for rescue therapy in multiresistant HIV infection, both in integrase inhibitor-naïve patients and in those previously treated with raltegravir or elvitegravir.
authors: Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, España; Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, España.
authors: Santiago
authors: S
authors: Moreno
authors: Unidad de Enfermedades Infecciosas-VIH, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España. Electronic address: jbb4@me.com.
authors: Juan
authors: J
authors: Berenguer
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D024921:Drug Resistance, Multiple, Viral; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D019428:HIV Integrase Inhibitors / Q000627:therapeutic use*; D015497:HIV-1 / Q000187:drug effects; D006575:Heterocyclic Compounds, 3-Ring / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010078:Oxazines; D010879:Piperazines; D011728:Pyridones; D016032:Randomized Controlled Trials as Topic; D016879:Salvage Therapy; D016896:Treatment Outcome; D000099226:Dolutegravir
chemical_list: D019380:Anti-HIV Agents; D019428:HIV Integrase Inhibitors; D006575:Heterocyclic Compounds, 3-Ring; D010078:Oxazines; D010879:Piperazines; D011728:Pyridones; D000099226:Dolutegravir
keywords: Antiretroviral therapy; Dolutegravir; Drug resistance; HIV; HIV integrase inhibitors; Inhibidores de la integrasa de VIH; Resistencia a fármacos; Tratamiento antirretroviral; VIH