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. 2018 Dec 10;6(1):ofy332.
doi: 10.1093/ofid/ofy332. eCollection 2019 Jan.

Virological Failure in HIV to Triple Therapy With Dolutegravir-Based Firstline Treatment: Rare but Possible

M J Pena  1 , N Chueca  2 , A D'Avolio  3 , J M Zarzalejos  4 , F Garcia  2
Affiliations

Virological Failure in HIV to Triple Therapy With Dolutegravir-Based Firstline Treatment: Rare but Possible

M J Pena et al. Open Forum Infect Dis. .

Abstract

We describe a case of virological failure during initial treatment with tenofovir disoproxil fumarate/emtricitabine/dolutegravir twice daily, with concomitant rifampin treatment of staphylococcal infection, selection of R263K + E157Q, and low plasma dolutegravir levels. Using rifampin together with dolutegravir may require closer follow-up, and, if possible, plasma dolutegravir levels should be monitored.

Keywords: dolutegravir; failure; firstline.

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Figures

Figure 1.
Figure 1.
Virological and immunological evolution of the patient since initiation of antiretroviral treatment. Dolutegravir levels are considered appropriate when they are above 640 ng/mL. Viral load is expressed as log RNA copies/mL; CD4 count is expressed as cells/μL. Abbreviations: BID, twice daily; DRVc, darunavir cobicistat; DTG, dolutegravir; FTC, emtricitabine; QD, once daily; RFP, rifampin; RPV, rilpivirine; TDF, tenofovir disoproxil fumarate.
See this image and copyright information in PMC

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