Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb 11;6(3):ofz056.
doi: 10.1093/ofid/ofz056. eCollection 2019 Mar.

No Significant Changes to Residual Viremia After Switch to Dolutegravir and Lamivudine in a Randomized Trial

Jonathan Z Li  1 , Paul E Sax  1 , Vincent C Marconi  2 , Jesse Fajnzylber  1 , Baiba Berzins  3 , Amesika N Nyaku  4 , Carl J Fichtenbaum  5 , Timothy Wilkin  6 , Constance A Benson  7 , Susan L Koletar  8 , Ramon Lorenzo-Redondo  3 , Babafemi O Taiwo  3
Affiliations

No Significant Changes to Residual Viremia After Switch to Dolutegravir and Lamivudine in a Randomized Trial

Jonathan Z Li et al. Open Forum Infect Dis. .

Abstract

In the ASPIRE trial, antiretroviral therapy (ART) switch to dolutegravir plus lamivudine (DTG+3TC) was comparable to 3-drug ART in maintaining viral suppression by standard viral load assays. We used an ultrasensitive assay to assess whether this switch led to increased residual viremia. At entry, levels of residual viremia did not differ significantly between arms (DTG+3TC vs 3-drug ART: mean, 5.0 vs 4.2 HIV-1 RNA copies/mL; P = .64). After randomization, no significant between-group differences were found at either week 24 or 48. These results show no evidence for increased viral replication on DTG+3TC and support its further investigation as a dual ART strategy.

Keywords: ART simplification; ART switch; dolutegravir; lamivudine; residual viremia.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Levels of HIV viral load by the ultrasensitive integrase single-copy assay by treatment arm at study entry, 24 and 48 weeks after antiretroviral therapy switch. Tukey’s box and whisker plots; box limits: interquartile range (IQR); middle line: median; diamond: mean; vertical lines: adjacent values (1st quartile −1.5 IQR; 3rd quartile +1.5 IQR). Abbreviations: 3TC, lamivudine; ART, antiretroviral therapy; DTG, dolutegravir.
See this image and copyright information in PMC

References

    1. Taiwo BO, Marconi VC, Berzins B, et al. . Dolutegravir plus lamivudine maintains human immunodeficiency virus-1 suppression through week 48 in a pilot randomized trial. Clin Infect Dis 2018; 66:1794–7. - PMC - PubMed
    1. Campillo-Gimenez L, Assoumou L, Valantin MA, et al. . ROCnRAL ANRS 157 Study Group Switch to maraviroc/raltegravir dual therapy leads to an unfavorable immune profile with low-level HIV viremia. AIDS 2015; 29:853–6. - PubMed
    1. Blanco JL, Rojas J, Paredes R, et al. . DOLAM Study Team Dolutegravir-based maintenance monotherapy versus dual therapy with lamivudine: a planned 24 week analysis of the DOLAM randomized clinical trial. J Antimicrob Chemother 2018; 73:1965–71. - PubMed
    1. Cillo AR, Vagratian D, Bedison MA, et al. . Improved single-copy assays for quantification of persistent HIV-1 viremia in patients on suppressive antiretroviral therapy. J Clin Microbiol 2014; 52:3944–51. - PMC - PubMed
    1. Li JZ, Etemad B, Ahmed H, et al. . The size of the expressed HIV reservoir predicts timing of viral rebound after treatment interruption. AIDS 2016; 30:343–53. - PMC - PubMed