Efficacy of dolutegravir + lamivudine q.d. with food in people with TB/HIV using a rifampicin-based regimen: A retrospective observational case series

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine Pub Date : 2024-03-17 DOI:10.1111/hiv.13632

Yanyun Dou, Ruichao Lu, Lingsong Su, Ke Lan, Zhihao Meng, Shanfang Qin, Liling Huang, Wei Huang, Yuanlong Xu, Yu Lv, Yuhong Wen, Shuanglai Lan, Yong Zuo, Yong Zhang

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引用次数: 0

Abstract

Objectives

Dolutegravir + lamivudine (DTG + 3TC) is a first-line regimen for people with HIV. However, there are still concerns about its efficacy in people with tuberculosis (TB)/HIV due to the lack of available evidence and drug–drug interaction with rifampicin.

Methods

A single-centre retrospective observational case series was conducted in Guangxi Zhuang Autonomous Region, China. We included all people with TB/HIV on combined use of once-daily (q.d.) dosing DTG + 3TC and rifampicin (RIF)-containing anti-TB regimens between 2020 and 2022. HIV-RNA, CD4 cell counts were collected and analysed.

Results

In all, 21 people with HIV (PWH) were included in this study. All the PWH were treatment-naïve and told to take DTG + 3TC q.d. with food. The median age was 53 years, and 71.43% were male. A total of 71.43% PWH had baseline viral load (VL) > 100 000 copies/mL, and 33.33% had baseline VL greater than 500 000 copies/mL. Only one PWH had CD4 cell count greater than 200 cells/μL, and the median CD4 count was 20 cells/μL. A total of 16 PWH started DTG + 3TC after initiation of the RIF-based anti-TB regimen, and the other five PWH initiated DTG + 3TC before the treatment of TB. All the PWH had at least 24 weeks of follow-up visits and all of the TB treatments were successful. A total of 20 PWH (95.24%) achieved viral suppression (VL <50 copies/mL). All detected viral loads between weeks 24 and 48 were less than 200 copies/mL. Among the PWH who started DTG + 3TC after the initiation of RIF-based anti-TB regimen, all achieved viral suppression by week 24 except the non-suppressed PWH. CD4 counts were greatly improved after antiretroviral treatment: the median CD4 counts were raised from 20 to 171 cells/μL at week 48. No serious adverse events were reported.

Conclusions

This case series preliminarily validates the efficacy of DTG + 3TC q.d. with food when combined with RIF-based anti-TB regimens in people with TB/HIV.

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多罗替拉韦+拉米夫定 q.d. 与食物一起服用对使用利福平方案的结核病/艾滋病患者的疗效：回顾性观察病例系列。

目标多托曲韦+拉米夫定（DTG+3TC）是艾滋病病毒感染者的一线治疗方案。然而，由于缺乏可用证据以及与利福平的药物相互作用，人们对其在结核病（TB）/艾滋病患者中的疗效仍存在担忧：方法：在中国广西壮族自治区开展了一项单中心回顾性观察病例系列研究。我们纳入了 2020 年至 2022 年期间联合使用每日一次（q.d.）剂量 DTG + 3TC 和利福平（RIF）抗结核方案的所有结核病/艾滋病毒感染者。收集并分析了 HIV-RNA 和 CD4 细胞计数：本研究共纳入 21 名艾滋病病毒感染者（PWH）。所有艾滋病病毒感染者均未接受过治疗，并被告知要在饭后服用 DTG+3TC q.d.。年龄中位数为 53 岁，71.43% 为男性。共有 71.43% 的 PWH 基线病毒载量（VL）大于 100 000 拷贝/毫升，33.33% 的 PWH 基线病毒载量大于 500 000 拷贝/毫升。只有一名 PWH 的 CD4 细胞计数大于 200 cells/μL，CD4 细胞计数中位数为 20 cells/μL。共有 16 名感染者在接受以 RIF 为基础的抗结核治疗后开始服用 DTG + 3TC，另外 5 名感染者在接受结核病治疗前开始服用 DTG + 3TC。所有感染者都接受了至少 24 周的随访，所有结核病治疗都取得了成功。共有 20 名感染者（95.24%）实现了病毒抑制（VL 结论）：本系列病例初步验证了 DTG + 3TC q.d. 与食物一起服用与基于 RIF 的抗结核治疗方案相结合对结核病/艾滋病毒感染者的疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.