title: Efficacy and tolerance of dolutegravir-based combined ART in perinatally HIV-1-infected adolescents: a French multicentre retrospective study.
abstract: To assess the safety and efficacy of a dolutegravir-based regimen in perinatally HIV-1-infected adolescents.
  
  
  
  We conducted a retrospective multicentre study of 50 adolescents beginning dolutegravir-based treatment regimens between January 2014 and December 2015. Clinical and biological data collected before and after dolutegravir initiation were analysed. The primary endpoint was the proportion of patients achieving a plasma viral load (PVL) <50 copies/mL within 3 months of dolutegravir initiation (for patients with detectable viraemia at baseline) and maintaining virological suppression (PVL <50 copies/mL) until the last follow-up visit (for all patients).
  
  
  
  Virological suppression was noted for 17/50 adolescents at baseline. Dolutegravir-based regimens maintained virological success in 14/17 patients (82%). The other three patients experienced a transient viral rebound, before PVL fell to < 50 copies/mL again, with no need to change the antiretroviral regimen. Thirty-three viraemic adolescents were enrolled. All but one had already received antiretroviral drugs. Virological success was achieved and maintained in 19/33 subjects (58%). Another three adolescents with initial virological failure had an undetectable PVL at the end of follow-up, with reinforced measures to improve compliance. Overall, sustained virological success was observed in 66% of patients and 78% of patients had an undetectable PVL at the last visit. Dolutegravir was well tolerated. Only one patient stopped treatment for severe drug-related adverse effects (dizziness and sleep disturbance). No emergence of resistance mutations was observed in patients with virological failure.
  
  
  
  Dolutegravir was safe and virologically effective in these patients, for whom multiple interventions were required to improve compliance.
authors.affiliation: Unité d'Immunologie, Hématologie et Rhumatologie Pediatriques, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Universitaire Necker - Enfants Malades, Paris, France.
authors.forename: Coralie
authors.initials: C
authors.lastname: Briand
authors.affiliation: Service d'Hématologie et Oncologie Pédiatrique, AP-HP, Hôpital Trousseau, Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Dollfus
authors.affiliation: Service de Pédiatrie Générale, AP-HP, Hôpital Robert Debré, Paris, France.|Université Paris Diderot, Sorbonne Paris Cité, INSERM 1123 (ECEVE), Paris, France.
authors.forename: Albert
authors.initials: A
authors.lastname: Faye
authors.affiliation: Département d'Anesthésiologie, AP-HP, Hôpital Bichat - Claude Bernard, Paris, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Kantor
authors.affiliation: Laboratoire de Microbiologie Clinique, AP-HP, Hôpital Universitaire Necker - Enfants Malades, Paris, France.|EA 7327, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Avettand-Fenoel
authors.affiliation: Service de Pédiatrie Générale, AP-HP, Hôpital Robert Debré, Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Caseris
authors.affiliation: Laboratoire de Virologie, AP-HP, Hôpital Bichat - Claude Bernard, F-75018 Paris, France.|IAME, INSERM UMR1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Diane
authors.initials: D
authors.lastname: Descamps
authors.affiliation: Laboratoire de Virologie, AP-HP, Hôpital Tenon, Paris, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Schneider
authors.affiliation: Service d'Hématologie et Oncologie Pédiatrique, AP-HP, Hôpital Trousseau, Paris, France.
authors.forename: Marie-Dominique
authors.initials: MD
authors.lastname: Tabone
authors.affiliation: Service d'Hématologie et Oncologie Pédiatrique, AP-HP, Hôpital Trousseau, Paris, France.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Vaudre
authors.affiliation: Unité d'Immunologie, Hématologie et Rhumatologie Pediatriques, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Universitaire Necker - Enfants Malades, Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Veber
authors.affiliation: Unité d'Immunologie, Hématologie et Rhumatologie Pediatriques, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Universitaire Necker - Enfants Malades, Paris, France.|EA 7323, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Blanche
authors.affiliation: Unité d'Immunologie, Hématologie et Rhumatologie Pediatriques, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Universitaire Necker - Enfants Malades, Paris, France.|Département d'Anesthésiologie, AP-HP, Hôpital Bichat - Claude Bernard, Paris, France.|Laboratoire de Microbiologie Clinique, AP-HP, Hôpital Universitaire Necker - Enfants Malades, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Frange
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D024882:Drug Resistance, Viral; D005260:Female; D005602:France; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D019428:HIV Integrase Inhibitors / Q000627:therapeutic use; D015497:HIV-1 / Q000187:drug effects*; D006575:Heterocyclic Compounds, 3-Ring / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D010078:Oxazines; D010879:Piperazines; D010949:Plasma / Q000821:virology; D011728:Pyridones; D012189:Retrospective Studies; D019562:Viral Load / Q000187:drug effects; 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