Virologic failure and HIV drug resistance on simplified, dolutegravir-based maintenance therapy: Systematic review and meta-analysis

About this activity

The concept of combination antiretroviral therapy (ART) for the treatment of HIV infection was established twenty years ago, when the results of the first studies evaluating protease inhibitor-based regimens were published. Due to its interesting pharmacokinetic profile, good tolerability and high barrier to resistance, dolutegravir (DTG), a new integrase strand transfer inhibitor (InSTI), has attracted much interest for its use in simplified treatment regimens. While preliminary analyses of a Dutch DTG monotherapy simplification trial seemed encouraging at 24 weeks, rates of virological failures increased significantly by week 48, suggesting a sub-optimal potency of this regimen. We performed a systematic review of the literature and a meta-analysis to provide precise estimates of the rate of virological failure (VF) and drug resistance in patients switched to a DTG-based maintenance mono- or dual therapy, and to clarify which drugs or combinations should be evaluated in further studi...