Effectiveness and Safety of Dolutegravir Plus Lamivudine Dual Therapy in Adult Patients with HIV Infection and AIDS at Srinagarind Hospital: A Retrospective Cohort Study
Keywords:
effectiveness, safety, adult patients with HIV infection and AIDS, dual therapy antiretroviral drugs, dolutegravir, lamivudineAbstract
Background and Objectives: According to the Thailand National guidelines on HIV/AIDS treatment and prevention 2021/2022, a three-drug antiretroviral therapy regimen is recommended as the first line treatment. However, certain patients may have limitations that prevent the use of standard three drug regimens. In such cases, dual drug regimen consisting of dolutegravir (DTG) and lamivudine (3TC) is recommended when an appropriate three drug regimen is not feasible. This study aimed to evaluate the effectiveness and safety of dual drug regimen to be a guidance of following up and follow up of adult HIV and AIDS in ensuring drug safety.
Methods: A retrospective cohort study was conducted among HIV-infected and AIDS patients receiving dual antiretroviral therapy regimen of DTG and 3TC at the Adult Infectious Diseases and AIDS Clinic, Srinagarind Hospital, from January 1, 2022 to December 31, 2024. Data were collected from the hospital’s electronic database and analyzed using descriptive statistics.
Results: A total of 268 patients participated in the study. The majority was male (59.7%). The mean age was 51.66 ± 11.81 years, and the average duration of dual antiretroviral therapy regimen of DTG and 3TC use was 19.10 ± 9.00 months. The primary reason for switching to this dual antiretroviral therapy regimen was decreased renal function (23.90%). In terms of treatment efficacy, 261 patients (97.40%) had an undetectable HIV viral load in the bloodstream after at least six months of treatment, cluster of differentiation 4 (CD4) counts significantly increased by 85.60 ± 114.40 cells/mm3 (from 553.30 ± 211.60 cells/mm3 to 638.80 ± 222.10 cells/mm3 (p < 0.001). Average viral load (VL), VL also significantly decreased (p = 0.004). Regarding safety, renal function significantly improved post switch, with the mean estimated glomerular filtration rate (eGFR) increasing from 71.73 ± 16.84 mL/min/ 1.73 m² to 75.3±19.09 mL/min/ 1.73 m² (p < 0.001), and mean serum creatinine (Scr) levels decreasing from 1.23 ± 0.26 mg/dL to 1.07 ± 0.26 mg/dL (a reduction of 0.05 ± 0.18 mg/dL, p < 0.001 )There were no statistically significant changes in lipid profiles, while 79.90% of patients experienced weight gain and increase body mass index (BMI).
Conclusion: The dual antiretroviral regimen including of DTG and 3TC is effective in suppressing HIV viral replication and has a favorable safety profile, particularly in improving renal function. It offers a viable alternative for patients who cannot tolerate standard three drug regimens.
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