DTG/3TC and B/F/TAF Results on HIV-1 Reservoir
The next is a abstract of “In-depth Evaluation of the HIV Reservoir Confirms Effectiveness and Security of Dolutegravir/Lamivudine in a Part 4 Randomized Managed Swap Trial (RUMBA)”, printed within the September 2024 challenge of Infectious Illnesses by Scheerder et al.
The objective of minimizing the long-term results of HIV therapy has led to analysis on 2-drug regimens (2DR), which prior research have proven similar to 3-drug regimens (3DR) by way of viral management and security.
Researchers carried out a retrospective research to analyze viral reservoirs, which have been important for the long-term security of the regimens regarding HIV-1 DNA copies, HIV-1 RNA transcripts, and sustained immunological management.
They used the Rumba research, the first potential randomized managed trial, to evaluate the impact of switching from 3DR to 2DR on the viral reservoir. Members with any steady 2nd era INSTI-based 3DR routine with HIV-1 RNA <50 copies/ml plasma for not less than 3 months have been randomized to modify to dolutegravir/lamivudine (DTG/3TC, N=89) or to modify or stay on bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF, N=45). Virological, immunological, and metabolic parameters have been evaluated after 48 weeks.
The outcomes confirmed no important distinction within the change over time within the imply variety of intact HIV-1 DNA copies/million CD4+ T cells between sufferers receiving dolutegravir/3TC and people receiving bictegravir/f/TAF. No proof was advised that switching to dolutegravir/3TC elevated the energetic reservoir of HIV-1 transcription, and no important adjustments in pro-inflammatory cytokines or main immune cell subsets have been noticed. Whereas there have been minor and bidirectional adjustments within the exhaustion and activation of particular mobile subsets, metabolic outcomes have been comparable between the two therapy regimens.
They concluded dolutegravir/3TC was as secure as bictegravir/f/TAF based mostly on viral management and in-depth investigations of the intact HIV-1 reservoir, HIV-1 transcription, and inflammatory markers.
Supply: tutorial.oup.com/jid/advance-article/doi/10.1093/infdis/jiae405/7748439
