Table 5.
Dolutegravir (DTG)-containing regimens in ART-experienced INSTI-naive persons
| AuthorYr | Population | Past ART | DTG ART (q24h) | Subjects | Weeks | Percentage VF (95% CI)a | Percentage resistance (95% CI)b |
|---|---|---|---|---|---|---|---|
| Aboud19 | RCT (DAWNING) | VF on a 1st-line NNRTI regimen | DTG + 2 NRTIs (1 NRTI predicted to be fully active) | 312 | 24 | 17.6 (13.7–22.4) | 0 (0–1.5) |
| 48 | 36.2 (30.9–41.8) | 0.6 (0.1–2.3) | |||||
| Cahn13 | RCT (SAILING) | h/o resistance to ≥2 ARV classes | DTG + OB (1 to 2 ARVs predicted to be fully active) | 354 | 48 | 29.1 (24.4–34.1) | 0.6 (0.1–2) |
| Vavro18 | trial (P1093) | heavily treated adolescents | DTG + OB | 61 | 48 | 31.1 (19.9–44.3) | 4.9 (1–13.7) |
| Lepik17 | cohort | infrequent h/o NRTI resistance (<10%) | DTG + 2 NRTIs | 252 | 48 | 16.7 (12.3–21.9) | 0.8 (0.1–2.8) |
| ALL, 48 weeksc | 979 | 48 | 28.0 (18.6–37.5), I2 = 91 | 0.7 (0.2–1.2), I2 = 0 |
OB, optimized background; W, weeks; h/o, history of.
VF, confirmed virus load ≥50 copies/mL or treatment discontinuation for any reason. For the cohort studies, the proportion of persons with VF after the median time of follow-up was provided.
Percentage of those receiving DTG ART developing an INSTI resistance mutation.
Pooled proportions and 95% CI of VF and VF with INSTI resistance estimated using a random-effects meta-regression. Follow-up meeting presentations provided additional drug resistance data for Aboud19 (DAWNING) and Cahn13 (SAILING). Vavro18 also included 5 day functional monotherapy in 10 patients and weight-adjusted dosing. The follow-up meeting presentation for the SAILING included additional cases of VF plus drug resistance after week 48.16