We report a case of sustained viral suppression with dolutegravir monotherapy in a treatment-experienced adult with perinatally acquired HIV. The patient had recurrent pancreatitis with multiple antiretroviral drugs, leading to discontinuation of antiretroviral therapy for several years. She was ultimately initiated on dolutegravir monotherapy two times per day via a gastrostomy tube. She did not develop any integrase strand transfer inhibitor mutations during the first 2 years on dolutegravir monotherapy. The patient has successfully maintained prolonged viral suppression for over 3 years with intermittent blips secondary only to intermittent medical issues. This case is unique in describing a highly treatment-experienced young adult with perinatal HIV infection who has been virally suppressed on dolutegravir monotherapy for a prolonged follow-up of 156 weeks.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8565549 | PMC |
| http://dx.doi.org/10.1136/bcr-2021-243685 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Prevalence of Emergent Dolutegravir Resistance Mutations in People Living with HIV: A Rapid Scoping Review.
Viruses
March 2024
Division of Infectious Diseases, Department of Medicine, Stanford University, Stanford, CA 94305, USA.
Article Synopsis
- Dolutegravir (DTG) is a highly effective medication in HIV treatment, but there's limited data on the risk of drug-resistance mutations arising in patients taking it.
- A review of 2131 studies showed that in various patient scenarios, the prevalence of drug-resistance mutations was generally low, particularly in trials involving experienced patients or those on monotherapy.
- To better understand drug-resistance risks, more innovative methods need to be applied in real-world studies, as trial data may not fully represent broader patient experiences.
A Comprehensive Literature Review of Treatment-Emergent Integrase Resistance with Dolutegravir-Based Regimens in Real-World Settings.
Viruses
December 2023
ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC 27701, USA.
After a decade of dolutegravir (DTG) use in various antiretroviral therapy combinations and in diverse populations globally, it is critical to identify HIV strains with reduced drug susceptibility and monitor emergent resistance in people living with HIV who experience virologic failure while on DTG-based regimens. We searched the PubMed, Embase, and Cochrane databases to identify studies that reported DTG resistance-associated mutations (RAMs) emerging under selection pressure. Our review showed that RAMs conferring resistance to DTG were rare in 2-drug and 3-drug regimens used in real-world cohorts, corroborating data from clinical trials.
View Article and Find Full Text PDFPrevalence of HIV drug resistance among adolescents receiving ART in Cameroon with low- or high-level viraemia.
J Antimicrob Chemother
December 2023
MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France.
Objectives: To characterize HIV drug resistance (HIVDR) below and above the WHO threshold of 1000 copies/mL, considered for the definition of HIV ART failure in resource-limited settings.
Methods: From a cohort of 280 adolescents (aged 10-19 years) receiving ART for at least 6 months, genotypic resistance testing (GRT) was attempted for two groups of participants: participants with low-level viraemia [LLV; viral load (VL) 200-999 copies/mL] and those in virological failure (VF; confirmed VL ≥1000 copies/mL) using an in-house method. The Stanford HIValg Program was used to identify relevant HIVDR mutations and predict the efficacy of the newly introduced tenofovir-lamivudine-dolutegravir combination.
HIV-1 drug resistance in people on dolutegravir-based antiretroviral therapy: a collaborative cohort analysis.
Lancet HIV
November 2023
Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland; Institute of Medical Virology, University of Zurich, Zurich, Switzerland.
Background: The widespread use of the integrase strand transfer inhibitor (INSTI) dolutegravir in first-line and second-line antiretroviral therapy (ART) might facilitate emerging resistance. The DTG RESIST study combined data from HIV cohorts to examine patterns of drug resistance mutations (DRMs) and identify risk factors for dolutegravir resistance.
Methods: We included cohorts with INSTI resistance data from two collaborations (ART Cohort Collaboration, International epidemiology Databases to Evaluate AIDS in Southern Africa), and the UK Collaborative HIV Cohort.
Laboratory Based Surveillance of HIV-1 Acquired Drug Resistance in Cameroon: Implications for Use of Tenofovir-Lamivudine-Dolutegravir (TLD) as Second- or Third-Line Regimens.
Viruses
August 2023
Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Messa, Yaoundé P.O. Box 3077, Cameroon.
Increased HIV drug resistance (HIVDR) with antiretroviral therapy (ART) rollout may jeopardize therapeutic options, especially in this era of transition to fixed-dose tenofovir-lamivudine-dolutegravir (TLD). We studied acquired HIVDR (ADR) patterns and describe potentially active drugs after first- and second-line failure in resource-limited settings (RLS) like Cameroon. A laboratory-based study with 759 patients (≥15 years) experiencing virological failure was carried out at the Chantal Biya International Reference Centre (CIRCB), Yaoundé, Cameroon.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!