Most cases of virologic failure on dolutegravir treatment for HIV are likely due to adherence problems and more time on treatment is needed before switching to another drug, according to new data from the ADVANCE trial.
Although the usual approach for someone in a clinical trial who experiences elevations in HIV RNA levels while on a dolutegravir-based treatment is to switch them to another therapy, the ADVANCE investigators opted for a different strategy.
Those who experience viremia on an integrase inhibitor such as dolutegravir should receive adherence counseling, have a repeat viral load test done in 3 months, and if their viral load is still elevated, be switched to another regimen. "What we saw was a faster time to re-suppression in the people followed-up long term on dolutegravir and also a higher percentage of people becoming suppressed when they remained on dolutegravir," he said.At 24 weeks after restarting treatment, 88% of people in the dolutegravir group had re-suppressed their viral RNA compared with 46% of people in the efavirenz group. At 48 weeks, those figures were 95% and 66%, respectively.
France Dernières Nouvelles, France Actualités
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