Dolutegravir for the treatment of HIV-2 infection

Abstract

Background: Therapeutic options are limited for HIV-2 infected persons, largely in part due to the lack of susceptibility to HIV-1 non-nucleoside reverse transcriptase inhibitors and poor susceptibility to some HIV-1 protease inhibitors. This is particularly worrisome for HIV-2 patients with prior antiretroviral failure.

Objectives: Report the virological response to dolutegravir in HIV-2-infected individuals.

Study design: Retrospective observational assessment of all HIV-2 individuals treated with dolutegravir in Spain.

Results: From 297 HIV-2-infected individuals recorded at the Spanish national registry, 26% received antiretroviral therapy. Six out of 8 failing on raltegravir selected for integrase resistance mutations N155H (4), Y143G (1) and Q148R (1). Two patients bearing N155H subsequently received dolutegravir. Both experienced initially more than 1.5 log drop in plasma HIV-2 RNA and significant CD4 gains. Whereas one kept on undetectable viremia 6 months later, the other experienced viral rebound.

Conclusion: Dolutegravir may be a good therapeutic option for patients with HIV-2 infection, including those that previously failed other integrase inhibitors.

Keywords: Antiretroviral therapy; Dolutegravir; Drug resistance; HIV-2; Raltegravir.