Dual therapy with renally adjusted lamivudine and dolutegravir: a switch strategy to manage comorbidity and toxicity in older, suppressed patients?

M. Tan, S. Johnston, J. Nicholls, M. Gompels*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

3 Citations (Scopus)
106 Downloads (Pure)

Abstract

Objectives: The aim of the study was to evaluate the efficacy of dual therapy with lamivudine (3TC), with dose adjustment for renal function, and dolutegravir (DTG) in a subgroup of patients fully suppressed on treatment who were switched because of concerns about comorbidity and toxicity on their current triple drug regimen.

Methods: A retrospective evaluation of clinical and pathological parameters from an electronic patient record from a single centre was carried out.

Results: There were no virological failures in 52 patients with a median age of 60.5 years. The median duration of follow-on dual therapy was 2.29 years (28 months; range 1.10–3.34 years). In 25 of 52 (48%) cases, the dose of 3TC was adjusted taking into account reduced renal function, and none of these patients experienced virological failure. Four additional patients discontinued early, because of side effects of the switch, with no failure.

Conclusions: This retrospective review suggests that 3TC and DTG may be effective in controlling viral load in older patients with comorbidities. This regimen appears to be a useful option in the context of comorbidities (including renal impairment) and polypharmacy in older patients. However, this review has been conducted in one centre and in a small population of patients. Therefore, further multicentre trials involving larger populations of patients are needed.

Original languageEnglish
Pages (from-to)634-637
Number of pages4
JournalHIV Medicine
Volume20
Issue number9
Early online date23 Jul 2019
DOIs
Publication statusPublished - 26 Sep 2019

Keywords

  • dolutegravir
  • dose adjustment
  • dual therapy
  • lamivudine
  • observational
  • simplification

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