Annals of medicine · 2026
Efficacy and metabolic outcomes of switching from an INSTI-based triple-drug regimen to dolutegravir/lamivudine in treatment-experienced HIV-1-infected patients: a 48-week real-world study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zhang Wei, Li Qisui, Deng Changgang, Yuan Jing
Аннотация
BACKGROUND: Real-world data on switching from INSTI-based triple therapy to DTG/3TC in the Chinese population are lacking.
METHODS: This retrospective study included 214 treatment-experienced patients with HIV from Chongqing Public Health Medical Center (2021-2022) on an INSTI-based triple-drug regimen for ≥6 months who switched to DTG/3TC for >12 months. Patients with pre-existing metabolic diseases were excluded. Participants were categorized: INSTI+TAF-free (n = 100, prior TDF/AZT/ABC), INSTI+TAF (n = 56, prior BIC/FTC/TAF), and INSTI+TAF+COBI (n = 58, prior EVG/c/FTC/TAF). Virological, immunological, and metabolic parameters were assessed at weeks 24 and 48.
RESULTS: The INSTI+TAF+COBI group was significantly older (p=0.000). Virological suppression rates (<50 copies/mL) were high at switch (93%, 85.7%, 91.4%). The INSTI+TAF+COBI group had lower eGFR and higher TG, TC, HDL, and LDL at baseline (p < 0.05). After switching, virological suppression remained high (≥90%) at weeks 24 and 48. CD4+ T-cell increases showed no significant intergroup differences. Metabolic changes differed: TC changes were 0.57 mmol/L (IQR: -0.19-0.91) in INSTI+TAF-free, -0.09 mmol/L (-0.47-0.71) in INSTI+TAF, and -0.25 mmol/L (-0.99-0.33) in INSTI+TAF+COBI. LDL changes were 0.23 mmol/L (-0.23-0.67), -0.15 mmol/L (-0.39-0.01), and -0.18 mmol/L (-0.71-0.10), respectively. TC and LDL changes differed significantly among groups (p < 0.05).
CONCLUSION: Switching to DTG/3TC maintained virological suppression and stable immunological outcomes. Patients previously on TAF-containing regimens demonstrated greater metabolic benefits than those on TAF-free regimens, possibly related to baseline TDF effects, requiring further confirmation.
METHODS: This retrospective study included 214 treatment-experienced patients with HIV from Chongqing Public Health Medical Center (2021-2022) on an INSTI-based triple-drug regimen for ≥6 months who switched to DTG/3TC for >12 months. Patients with pre-existing metabolic diseases were excluded. Participants were categorized: INSTI+TAF-free (n = 100, prior TDF/AZT/ABC), INSTI+TAF (n = 56, prior BIC/FTC/TAF), and INSTI+TAF+COBI (n = 58, prior EVG/c/FTC/TAF). Virological, immunological, and metabolic parameters were assessed at weeks 24 and 48.
RESULTS: The INSTI+TAF+COBI group was significantly older (p=0.000). Virological suppression rates (<50 copies/mL) were high at switch (93%, 85.7%, 91.4%). The INSTI+TAF+COBI group had lower eGFR and higher TG, TC, HDL, and LDL at baseline (p < 0.05). After switching, virological suppression remained high (≥90%) at weeks 24 and 48. CD4+ T-cell increases showed no significant intergroup differences. Metabolic changes differed: TC changes were 0.57 mmol/L (IQR: -0.19-0.91) in INSTI+TAF-free, -0.09 mmol/L (-0.47-0.71) in INSTI+TAF, and -0.25 mmol/L (-0.99-0.33) in INSTI+TAF+COBI. LDL changes were 0.23 mmol/L (-0.23-0.67), -0.15 mmol/L (-0.39-0.01), and -0.18 mmol/L (-0.71-0.10), respectively. TC and LDL changes differed significantly among groups (p < 0.05).
CONCLUSION: Switching to DTG/3TC maintained virological suppression and stable immunological outcomes. Patients previously on TAF-containing regimens demonstrated greater metabolic benefits than those on TAF-free regimens, possibly related to baseline TDF effects, requiring further confirmation.