Scientific Poster Session III - Students Research-in-Progress

Students Research in Progress
  Monday, October 14, 2024
  01:00 PM–02:30 PM

Abstract

Introduction: Dolutegravir/lamivudine (DTG/3TC) is a switch option for virologically suppressed patients living with HIV (PLWH) on stable antiretroviral therapy (ART) and initial therapy for treatment-naive patients meeting specific criteria. We describe DTG/3TC use in a real world setting at Cleveland Clinic.

Research Question or Hypothesis: How is DTG/3TC prescribed and what are the virologic outcomes in PLWH started on DTG/3TC at Cleveland Clinic?

Study Design: Retrospective chart review from 6/15/2019 through 6/30/2024 at Cleveland Clinic Main Campus.

Methods: Objectives include: 1) describe patient population receiving DTG/3TC and 2) determine rate and duration of maintained HIV virologic suppression (less than 50 copies/mL) in patients switching to DTG/3TC from other ART. Included patients were 18 years and older receiving at least one DTG/3TC prescription for HIV treatment. Excluded patients did not have follow-up HIV viral load after starting DTG/3TC or received less than two months of therapy. Descriptive statistics performed with percentages, median, and interquartile range.

Results: Fifty-three patients were included (treatment-experienced n=52, treatment-naïve n=1). Patients were male (86.8%), white (47.1%), 52 years of age (median), with median 10 years since HIV diagnosis. Two most common ART prior to DTG/3TC switch included dolutegravir/lamivudine/abacavir (40.4%) and bictegravir/emtricitabine/tenofovir alafenamide (25%). For treatment-experienced, 94.2% (49/52) were virologically suppressed at DTG/3TC initiation, 100% suppressed at first follow-up, and 98.1% (51/52) suppressed at most recent visit at median 15 months (IQR 9-29 months). No patients had a viral load >200 copies/mL. The treatment-naive patient demonstrated down-trending viral loads since DTG/3TC initiation. Eleven percent (6/53) of patients discontinued DTG/3TC due to changes in renal function, change to injectable ART, or pregnancy.

Conclusion: In a real-world population, DTG/3TC successfully maintained and/or instigated virologic suppression in those who were both treatment-naive and experienced. Rates of discontinuation were similar or higher than previously reported.

Presenting Author

Maya Pedersen BSPS, PharmD Candidate
Cleveland Clinic Health System

Authors

Francisco Marco Canosa MD
Cleveland Clinic Heatlh System

Andrea Pallotta PharmD, BCPS, BCIDP, AAHIVP
Cleveland Clinic