Dolutegravir 50 mg + Rilpivirine 25 mg (DTV + RPV) Daily in Treatment-Experienced HIV-Infected Patients

Abstract

Background. DTV + RPV is currently being studied in phase III as a maintenance regimen for antiretroviral therapy (ART)-naive patients who achieve undetectable viral load (VL) on a triple-drug regimen. This paper will discuss real-life clinical results in patients who were switched to DTV + RPV for reasons other than simplification or maintenance. Methods. An observational retrospective study conducted in an inner city HIV clinic identified 14 patients who received DTV + RPV after failing a prior regimen. Gender, race, prior ART, resistance profiles, baseline VL and CD4+ count were captured, and patients were followed up to 1 May 2016 to determine outcome. Results. Six out of 14 are African American, 6 are Caucasian, and 7 are males. Prior to the switch to DTV + RPV, 4 regimens were NNRTI-based, 5 contained protease inhibitors, 6 contained integrase inhibitors, and 11 had a regimen with a two-NRTI backbone. Half of the patients had developed resistance to their previous regimens, with four patients having 2 class-resistance and 3 resistant only to NRTIs. Nine patients had intolerance to their prior regimens. As of 1 May 2016, patients had a combined total of 599 weeks of VL <20 copies/mL on DTV + RPV. No adverse events were identified. Conclusion. The results of this study suggest that this combination is both safe and well tolerated in patients who had experienced adverse events to previous ART. Also DTV + RPV seem very efficacious in suppressing HIV VL in those with prior resistance. A larger study using this regimen will be needed to confirm its long-term efficacy and safety.