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Objectives:  To evaluate the impact of a treatment switch to dolutegravir plus lamivudine on the soluble inflammatory biomarkers of HIV-infected patients treated in a real-life setting. Materials and methods:  This was a longitudinal study that enrolled virologically-suppressed patients on stable 3-drug ART who switched at baseline to dolutegravir + lamivudine (2DR-group), based on the clinician’s decision, or maintained triple therapy (3DR-group). Subjects in the 3DR-group were matched with those in the 2DR-group for age, gender and type of anchor drug. Plasma levels of interleukin-6 (IL-6), I-FABP, D-dimer and C-reactive protein (CRP) were quantified by a microfluidic ultrasensitive ELISA assay at baseline and at 48 weeks. Results:  Overall 208 subjects were enrolled: 101 in the 2DR-group and 107 in the 3DR-group. At baseline, biomarker levels were comparable between groups. The differences in mean log 10  change from baseline to 48 weeks between groups (2DR versus 3DR) were: IL-6 (pg/L) −0.051(95% CI −0.115/0.009) versus 0.004 (95% CI −0.046/0.054) (p = 0.159); I-FABP (pg/mL), −0.088 (95% CI −0.14/-0.041) versus 0.033 (95%CI −0.007/0.072) (p &lt; 0.001); D-dimer (pg/mL), −0.011(95% CI-0.055/0.033) versus −0.021 (95% CI −0.071/0.030) (p = 0.780) and CRP (pg/mL), −0.028 (95%CI −0.118/0.063) versus 0.118 (95% CI 0.024/0.211) (p = 0.028). Conclusions:  At 1 year, switching to a dolutegravir plus lamivudine dual regimen in this setting showed a favorable trend for two biomarkers analyzed, i.e., I-FABP and CRP, as compared to continuing a triple therapy. These results add important new data in support of the safety of this approach in terms of its effect on the inflammatory milieu.

hiv research and clinical practice

Inflammation markers in virologically suppressed HIV-Infected patients after switching to dolutegravir plus lamivudine vs continuing triple therapy: 48-week results in real-life setting