Open AccessSwitch to dolutegravir is well tolerated in Thais with HIV infection
Author(s) -
Goh Orlanda Q,
Colby Donn J,
Pinyakorn Suteeraporn,
Sacdalan Carlo,
Kroon Eugène,
Chan Phillip,
Chomchey Nitiya,
Kanaprach Ratchapong,
Prueksakaew Peeriya,
Suttichom Duanghathai,
Trichavaroj Rapee,
Spudich Serena,
Robb Merlin L,
Phanuphak Praphan,
Phanuphak Nittaya,
Ananworanich Jintanat
Publication year - 2019
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.1002/jia2.25324
Subject(s) - dolutegravir , medicine , thais , human immunodeficiency virus (hiv) , virology , integrase , antiretroviral therapy , darunavir , viral load , demography , sociology
Dolutegravir ( DTG ) is recommended as part of first‐line antiretroviral therapy ( ART ) for people living with HIV (PLHIV). We sought to determine the rate of adverse events ( AE s) and discontinuations among Thais treated during acute HIV infection ( AHI ) and switched to DTG ‐based regimens. Methods Thai participants in the SEARCH 010/ RV 254 cohort who initiated ART during AHI and switched to DTG for at least 48 weeks were prospectively observed and included in the analysis. Rates and characteristics of DTG ‐related AE s and discontinuations were described. Results A total of 313 Thai participants were included in the analysis. The median age was 29 years, 96% were male, 64% had a Bachelor's degree or higher and 16% had a body mass index ( BMI ) <18.5 kg/m 2 . Participants were on ART for a median of 124 weeks before switching to DTG . The median ( IQR ) body weight increased from 63 (56 to 70) kg before to 65 (58 to 73) kg ( p < 0.0001) after 48 weeks of DTG . Forty‐nine (16%) developed DTG ‐related AE s, corresponding to an incidence of 16.6 per 100 person‐years. Neuropsychiatric symptoms were most frequently encountered (n = 25, 8%), followed by laboratory abnormalities (n = 16, 5%). Six (2%) discontinued DTG , corresponding to an incidence of 2.4 per 100 person‐years. All discontinuations were due to increased liver enzymes in the presence of hepatitis C virus coinfection. In the multivariate analysis, incident hepatitis C virus infection was the only risk factor for discontinuing DTG (hazard ratio 59.4, 95% CI 8.5 to 297.9, p < 0.0001). Neither low BMI nor concurrent abacavir therapy was associated with discontinuation. Conclusions DTG was well tolerated with few discontinuations in this cohort of young men. Incident hepatitis C virus infection was a driver of liver‐related AE s leading to discontinuations. In populations at risk, regular testing for hepatitis C virus during ART is recommended to anticipate possible AE s, guide management and improve safety.