Efficacy of Dolutegravir Plus Lamivudine in People With TB/HIV Co-Infection Using a Rifampicin or Rifabutin-Based Regimen: A Retrospective Observational Case Series.

INTRODUCTION

Co-infection with tuberculosis (TB) is the leading cause of death in individuals infected with human immunodeficiency virus (HIV)-1. Dolutegravir and lamivudine (DTG + 3TC) has recently been recommended as the preferred first-line regimen for the treatment of new and treatment-experienced HIV-infected patients. The primary objective of this study was to determine the efficacy and safety of DTG (50 mg) + 3TC (300) mg in HIV-positive antiretroviral therapy (ART)-naïve patients with TB who received a rifampicin- or rifabutin-based treatment regimen and characterize viral suppression rates at week 48.

METHODS

A single-center retrospective observational case series, spanning January 1, 2021 to March 1, 2023, was conducted in Guiyang Public Health Treatment Center. Of 46 TB/HIV co-infected patients received DTG + 3TC or DTG/3TC, a total of 42 patients were finally enrolled in the study. The outcomes of interest were successful TB treatment, viral load (VL) suppression, and immunological and biochemical indexes.

RESULTS

All people with HIV infection (PWH) underwent at least 48 weeks of follow-up; all TB treatments were successful. A total of seven PWH (100%) achieved viral suppression (VL < 50 copies/mL) from a baseline VL greater than 500,000 copies/mL. Among the PWH who started DTG + 3TC after initiating the rifabutin-based anti-TB regimen, 31 (73.8%) achieved viral suppression by week 24. CD4 + T-cell counts were greatly improved after antiretroviral treatment. The CD4 + /CD8+ ratio increased by 0.38 (p < 0.001). Total cholesterol, and high-density lipoprotein cholesterol (p < 0.05). There were no significant changes in body mass index, low-density lipoprotein cholesterol, and triglyceride levels from baseline to week 48 (p > 0.05). No serious adverse events were observed.

CONCLUSION

This case series preliminarily validated the efficacy of DTG + 3TC when combined with rifabutin-based anti-TB regimens in patients with TB and HIV.