People who switch to dolutegravir plus lamivudine (Dovato) have a high likelihood of maintaining an undetectable viral load even if they have a history of treatment failure and a common resistance mutation. The SOLAR-3D trial looked at outcomes among 100 treatment-experienced people on suppressive antiretroviral therapy—mostly three-drug regimens—-who switched to dolutegravir/ lamivudine. Half had the M184V/I mutation, which confers resistance to lamivudine and emtricitabine, now or in the past. At 96 weeks after the switch, only 15 people who once had M184V/I still showed evidence of the mutation in their viral reservoir. At that point, 84% of people who ever had M184V/I and 88% of those who never did maintained an undetectable viral load. Three people experienced viral blips, but all regained viral suppression without changing their regimen. Switching from three to two drugs could potentially lead to cost savings “in the billions,” said Gary Blick, MD, of Health Care Advocates International.
Treatment: Drug Resistance
A trial looked at outcomes among treatment-experienced people on suppressive antiretroviral therapy who switched to dolutegravir/lamivudine.