Stable HIV-1 reservoirs on dolutegravir maintenance monotherapy: the MONODO study.
- Sculier D Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
- Doco-Lecompte T Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
- Yerly S Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland.
- Metzner KJ Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
- Decosterd LA Division of Clinical Pharmacology, University Hospital and University of Lausanne, Lausanne, Switzerland.
- Calmy A Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
- 2018-06-23
Published in:
- HIV medicine. - 2018
English
OBJECTIVES
Dolutegravir (DTG) is a highly effective integrase inhibitor with a strong genetic resistance barrier and a potential role in simplified HIV maintenance treatment. We assessed the feasibility of DTG maintenance monotherapy and measured HIV reservoirs on DTG monotherapy.
METHODS
An interventional, open-label, single-arm study including eight virologically suppressed HIV-1-infected patients switched to DTG 50 mg once daily for 24 weeks was performed. HIV-1 RNA levels in plasma and cerebrospinal and seminal fluids were measured at baseline and week 24, as well as HIV-1 DNA in peripheral cells and DTG concentrations in these compartments.
RESULTS
HIV-1 RNA remained undetectable in all samples of blood, cerebrospinal fluid and sperm throughout the 24 weeks, except for one cerebrospinal fluid sample with a value of 28 HIV-1 RNA copies/mL at week 24. One patient discontinued the study because of a neurological side effect. There was no change in the mean HIV-1 DNA level between baseline and week 24. Plasma and cerebrospinal fluid DTG concentrations reached therapeutic levels in all patients in these two compartments.
CONCLUSIONS
In this small sample of carefully selected patients, HIV-1 reservoirs were well controlled on DTG monotherapy over a period of 24 weeks. Viral suppression was also maintained throughout follow-up.
Dolutegravir (DTG) is a highly effective integrase inhibitor with a strong genetic resistance barrier and a potential role in simplified HIV maintenance treatment. We assessed the feasibility of DTG maintenance monotherapy and measured HIV reservoirs on DTG monotherapy.
METHODS
An interventional, open-label, single-arm study including eight virologically suppressed HIV-1-infected patients switched to DTG 50 mg once daily for 24 weeks was performed. HIV-1 RNA levels in plasma and cerebrospinal and seminal fluids were measured at baseline and week 24, as well as HIV-1 DNA in peripheral cells and DTG concentrations in these compartments.
RESULTS
HIV-1 RNA remained undetectable in all samples of blood, cerebrospinal fluid and sperm throughout the 24 weeks, except for one cerebrospinal fluid sample with a value of 28 HIV-1 RNA copies/mL at week 24. One patient discontinued the study because of a neurological side effect. There was no change in the mean HIV-1 DNA level between baseline and week 24. Plasma and cerebrospinal fluid DTG concentrations reached therapeutic levels in all patients in these two compartments.
CONCLUSIONS
In this small sample of carefully selected patients, HIV-1 reservoirs were well controlled on DTG monotherapy over a period of 24 weeks. Viral suppression was also maintained throughout follow-up.
- Language
-
- English
- Open access status
- hybrid
- Identifiers
-
- DOI 10.1111/hiv.12626
- PMID 29932298
- Persistent URL
- https://sonar.ch/global/documents/91783
Statistics
Document views: 68
File downloads:
- Full-text: 0