Efficacy and tolerance of dolutegravir-based combined ART in perinatally HIV-1-infected adolescents: a French multicentre retrospective study

• Published in: Journal of antimicrobial chemotherapy Vol. 72; no. 3; p. dkw464
• Main Authors: Briand, Coralie, Dollfus, Catherine, Faye, Albert, Kantor, Elie, Avettand-Fenoel, Véronique, Caseris, Marion, Descamps, Diane, Schneider, Véronique, Tabone, Marie-Dominique, Vaudre, Geneviève, Veber, Florence, Blanche, Stéphane, Frange, Pierre
• Format: Journal Article
• Language: English
• Published: England 01.03.2017
• Subjects: Adolescent; Anti-HIV Agents - therapeutic use; Antiretroviral Therapy, Highly Active; Drug Resistance, Viral; Female; France; Heterocyclic Compounds, 3-Ring - administration & dosage; Heterocyclic Compounds, 3-Ring - adverse effects; Heterocyclic Compounds, 3-Ring - therapeutic use; HIV Infections - drug therapy; HIV Infections - virology; HIV Integrase Inhibitors - therapeutic use; HIV-1 - drug effects; Humans; Infectious Disease Transmission, Vertical; Male; Plasma - virology; Retrospective Studies; Viral Load - drug effects
• ISSN: 0305-7453; 1460-2091; 1460-2091
• DOI: 10.1093/jac/dkw464

To assess the safety and efficacy of a dolutegravir-based regimen in perinatally HIV-1-infected adolescents. We conducted a retrospective multicentre study of 50 adolescents beginning dolutegravir-based treatment regimens between January 2014 and December 2015. Clinical and biological data collected before and after dolutegravir initiation were analysed. The primary endpoint was the proportion of patients achieving a plasma viral load (PVL) <50 copies/mL within 3 months of dolutegravir initiation (for patients with detectable viraemia at baseline) and maintaining virological suppression (PVL <50 copies/mL) until the last follow-up visit (for all patients). Virological suppression was noted for 17/50 adolescents at baseline. Dolutegravir-based regimens maintained virological success in 14/17 patients (82%). The other three patients experienced a transient viral rebound, before PVL fell to < 50 copies/mL again, with no need to change the antiretroviral regimen. Thirty-three viraemic adolescents were enrolled. All but one had already received antiretroviral drugs. Virological success was achieved and maintained in 19/33 subjects (58%). Another three adolescents with initial virological failure had an undetectable PVL at the end of follow-up, with reinforced measures to improve compliance. Overall, sustained virological success was observed in 66% of patients and 78% of patients had an undetectable PVL at the last visit. Dolutegravir was well tolerated. Only one patient stopped treatment for severe drug-related adverse effects (dizziness and sleep disturbance). No emergence of resistance mutations was observed in patients with virological failure. Dolutegravir was safe and virologically effective in these patients, for whom multiple interventions were required to improve compliance.