title: Dolutegravir-based monotherapy or dual therapy maintains a high proportion of viral suppression even in highly experienced HIV-1-infected patients.
abstract: BACKGROUND
  Dolutegravir is a powerful, well-tolerated integrase inhibitor with a high genetic barrier to resistance and may thus constitute the backbone of lightened regimens.
  
  
  METHODS
  This was a monocentric, retrospective study. HIV-1-infected patients receiving dolutegravir as monotherapy (mDGV) or dual therapy (dDGV) were systematically identified. The primary outcome was the proportion of patients who maintained undetectable (<50 copies/mL) plasma HIV RNA [plasma viral load (PVL)].
  
  
  RESULTS
  We identified 21 patients on mDGV (50 mg/day) and 31 on dDGV (50 or 100 mg/day, with atazanavir  ±  ritonavir, n = 12; rilpivirine, n = 11; maraviroc, n = 3; lamivudine, n = 3; darunavir/ritonavir, n = 1; or abacavir, n = 1). All of the patients were treatment experienced and 48% had experienced at least one virological failure. The baseline characteristics were as follows (for the mDGV/dDGV patients, respectively): 5%/29% had a history of AIDS; the median (IQR) highest PVL was 4.5 (4.3-5.5)/5.3 (4.7-5.6) log copies/mL; the median (IQR) nadir CD4+ count was 310 (280-468)/199 (134-281) cells/mm(3); 100% had undetectable PVL before the mDGV for a median (IQR) duration of 5.9 (3.5-9.9) years/81% had undetectable PVL before the dDGV for a median (IQR) duration of 3.7 (1.4-8.3) years; and the median (IQR) HIV DNA level was 2.7 (2.1-3.1)/2.9 (2.7-3) log copies/10(6) PBMCs. At the last follow-up visit, 100% and 97% of patients showed undetectable PVL following mDGV and dDGV, respectively [median (IQR) follow-up of 32 (29-45) and 50 (30-74) weeks, respectively].
  
  
  CONCLUSIONS
  In our experience, dolutegravir-based lightened regimens provided a high proportion of viral suppression, even in highly treatment-experienced patients.
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional, Orléans, France.
authors.forename: Camelia
authors.initials: C
authors.lastname: Gubavu
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional, Orléans, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Prazuck
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional, Orléans, France.
authors.forename: Mohamadou
authors.initials: M
authors.lastname: Niang
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional, Orléans, France.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Buret
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional, Orléans, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Mille
authors.affiliation: Laboratoire de Virologie, Centre Hospitalier Régional, Orléans, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Guinard
authors.affiliation: Laboratoire de Virologie, Hôpital Necker-Enfants Malades, APHP, Paris, France Université Paris-Descartes Sorbonne Paris Cité, Faculté de Médecine, EA 7327, Paris, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Avettand-Fènoël
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional, Orléans, France laurent.hocqueloux@chr-orleans.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Hocqueloux
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D024882:Drug Resistance, Viral; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006575:Heterocyclic Compounds, 3-Ring / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010078:Oxazines; D010879:Piperazines; D011728:Pyridones; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome; D019562:Viral Load; D000099226:Dolutegravir
chemical_list: D019380:Anti-HIV Agents; D006575:Heterocyclic Compounds, 3-Ring; D010078:Oxazines; D010879:Piperazines; D011728:Pyridones; D000099226:Dolutegravir