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Can dolutegravir dual therapy or monotherapy produce and maintain HIV suppression?
Liz Highleyman, 2015-10-23 08:00:00
The potent integrase
inhibitor dolutegravir taken with a single well-tolerated NRTI was able to fully
suppress viral load in people initiating antiretroviral treatment for the first
time, while dolutegravir alone was able to keep HIV suppressed in most treatment-experienced
people who started with undetectable viral load, according to a set of studies
presented yesterday at the 15th
European AIDS Conference
in Barcelona, Spain.
presentations, experts offered evidence in favour of and opposed to simplifying
treatment by reducing drug burden, disagreeing about whether this strategy is
beneficial or too risky.
As people living with HIV
continue to face decades on treatment, researchers have attempted to find
regimens that are better tolerated, simpler and easier to take. Non-standard
antiretroviral therapy (ART) may be especially beneficial for heavily
treatment-experienced patients with drug-resistant virus and those who cannot tolerate
drug side-effects. Using a single potent drug alone would reduce pill burden
and toxicities, but protease inhibitor monotherapy studies to date have yielded
ViiV Healthcare's integrase
inhibitor dolutegravir (Tivicay, also
in the Triumeq single-tablet regimen)
has demonstrated potent antiviral activity – reducing viral load by an
impressive 2.5 log10 in an early 10-day monotherapy study – and a
high barrier to resistance, making it an attractive prospect for streamlined
therapy. It is well-tolerated and does not have the toxicities and drug-drug
interactions seen with the protease inhibitor class.