Milka A. Rodriguez1, Anthony Mills2, Adam Stoker2, Suqin Cai1, Dusica Curanovic1, Christos Petropoulos1 and Charles Walworth1
Background: HIV-1 DNA drug resistance testing is increasingly used to guide antiretroviral (ARV) regimen switches in the setting of viral suppression. In this single-arm study, HIV-1 DNA resistance testing was used to assess eligibility for the fixed-dose combination of abacavir/ dolutegravir/lamivudine in the context of a switch study evaluating changes in bone mineral density in HIV-1 positive adults ages 50 years and older. Methods: Study subjects had viral loads which were <50 copies/mL at study screening. Susceptibility to each component of the switch regimen was assessed using an HIV-1 DNA genotypic resistance assay. A regimen switch was made only when the subject’s virus was sensitive to each component of the switch regimen. Viral load measurements were obtained per study protocol through weeks 24 and 48. Results: At week 24, the HIV-1 RNA viral load was <50 copies/mL for 44 of 44 study participants with available follow-up data, (95% CI [0.920, 1]). At week 48, 41 of 42 participants were virologically suppressed to <50 copies/mL, (95% CI [0.874, 0.999]); 1 participant had a viral load of 62 copies/mL. Conclusion: In this pre-selected population of virologically suppressed patients, HIV-1 DNA resistance testing successfully identified candidates for ARV treatment modification to an available single tablet regimen. These results support the utility of HIV-1 DNA drug resistance testing in the clinical setting.
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