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- Title
Efficacy and tolerance of dolutegravir-based combined ART in perinatally HIV-1-infected adolescents: a French multicentre retrospective study.
- Authors
Briand, Coralie; Dollfus, Catherine; Faye, Albert; Kantor, Elie; Avettand-Fenoel, Véronique; Caseris, Marion; Descamps, Diane; Schneider, Véronique; Tabone, Marie-Dominique; Vaudre, Geneviève; Veber, Florence; Blanche, Stéphane; Frange, Pierre
- Abstract
<bold>Objectives: </bold>To assess the safety and efficacy of a dolutegravir-based regimen in perinatally HIV-1-infected adolescents.<bold>Patients and methods: </bold>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).<bold>Results: </bold>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.<bold>Conclusions: </bold>Dolutegravir was safe and virologically effective in these patients, for whom multiple interventions were required to improve compliance.
- Subjects
FRANCE; ANTIRETROVIRAL agents; HIV infections; THERAPEUTICS; DRUG efficacy; DRUG tolerance; ADOLESCENT health; ANTI-HIV agents; HIV integrase inhibitors; BLOOD plasma; COMPARATIVE studies; DRUG resistance in microorganisms; HETEROCYCLIC compounds; HIV; RESEARCH methodology; MEDICAL cooperation; RESEARCH; VIRAL load; EVALUATION research; HIGHLY active antiretroviral therapy; RETROSPECTIVE studies; VERTICAL transmission (Communicable diseases)
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2017, Vol 72, Issue 3, p837
- ISSN
0305-7453
- Publication type
journal article
- DOI
10.1093/jac/dkw464