HIV-1-infection Clinical Trial
Official title:
Real Life Study of Dolutegravir Plus Lamivudine in HIV-1-Infected Treatment-Naive Patients
Thanks to the actual highly active antiretroviral therapy (HAART) patients living with HIV
have a better life expectancy, becoming chronical patients. Today's antiretroviral treatment
(ART) must be maintained for life to prevent disease progression until a cure is reached.
Given this need, ARTs are becoming safer and more effective but are still toxic. Cause of
that simplification therapies are real, reducing the number of different Antiretrovirals
involved controlling the infection. This strategies include from monotherapy using/with
protease inhibitors (PI), which was investigated with treatment-experienced patients and
virologically suppressed, to dual therapies which recently were investigated in
treatment-naïve and treatment-experienced patients with combinations such as dolutegravir
(DTG) plus lamivudine (3TC), Dolutegravir plus rilpivirine or rilpivirine plus
darunavir/ritonavir boosted.
Nowadays dual therapy in real life (not into the context of a clinical trial) with
dolutegravir plus lamivudine is largely studied in treatment-experienced patients who are
virologically suppressed and got nearly a 100% efficacy results. Recently published results
from clinical trials in treatment-naïve patients GEMINI 1 &2, where efficacy of the dual
therapy with DTG 50mg plus 3TC 300mg/QD was compared versus the efficacy of triple therapy
with tenofovir disoproxil fumarate, emtricitabine and dolutegravir (TDF/FTC+ DTG) (QD). Both
trials show similar efficacy results, with virologic suppression higher than 90% at week 48.
Clinical trials are the gold standard to approve and add to the clinical practice new drugs
and new therapies, but is also known that have some inconvenient like strict
inclusion-exclusion criteria which put the study population far from being a real sample.
Studies with real world data (RWD) have several strengths such as quality in medical
attention and works like a bridge between clinical trials and standard clinical care,
reducing/lowering general costs, improving results and accelerating the generation of
knowledge.
For all the reasons above, the primary objective of this study is to analyze in
treatment-naïve HIV patients the effectiveness in real life of 3TC (300 mg p.o. q 24 h) plus
DTG (50 mg p.o. q 24 h). Secondary objectives are: to describe the patient who receive this
dual therapy, to quantify the time gap between the clinic visit and the first dose of dual
therapy administrated evaluating this dual therapy as candidate to "test and treat"
therapies; to analyze the viral load drop and the increase of cluster of differentiation 4
(CD4) T lymphocytes levels; To analyze virological failures and previous mutations influence
in basal resistance tests; and finally a pharmacoeconomic analysis, safety of the treatment
and adherence to the healthcare system.
n/a
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