1392. Darunavir and Dolutegravir Combination Therapy in ART experienced HIV-infected Patients: A Preliminary Report. Alexandra Stang, Tracy Perry, Nada Fadul
Session: Poster Abstract Session: HIV: Antiretroviral Therapy
Friday, October 6, 2017
Room: Poster Hall CD
Posters
  • DRV DTG poster.pdf (535.0 kB)
  • Background: Patients with HIV may require change in therapy for simplification, salvage, or to avoid side effects. There is limited data on the use of dolutegravir (DTG) and ritonavir- or cobicistat-boosted darunvair (DRV) combination therapy alone or with additional active agents in patients with HIV. The objectives of this study were to describe the current use and indications of DTG/DRV combination and to evaluate its effectiveness on viral load suppression (VLS).

    Methods: A retrospective chart review of HIV-infected patients, 18 years or older, seen at our clinic between August 2013 and December 2015 who were on DRV/DTG combination alone or with additional active agents was conducted. Demographic, clinical, and laboratory information was collected. Descriptive statistics were used for data analysis.

    Results: Eighty-seven patients were included in the study: 64 (74%) on DRV/DTG alone and 23 (26%) on DRV/DTG plus additional agents. Mean age was 49.3 (18-79); 29 (33.3%) were female; and 77 (89%) were black. Coronary artery disease (CAD) or CAD equivalent was present in 27 (31%), chronic kidney disease in 24 (28%), and chronic hepatitis B infection in 3 (3%) patients. The majority 86 (99%) of patients were treatment experienced; 60 (69%) had been treated with 3 or more antiretroviral drug classes; 57 (66%) were integrase experienced, including 6 (6.9%) with baseline integrase resistance. Baseline HIV viral load was >200 copies/mL in 41 (47%); and CD4 count was <200 in 29 (33%) patients. Reason for switch was reported as salvage in 42 patients (48%) simplification in 33 patients (38%), renal impairment in 11 patients (13%), and other in 6 patients (7%). VLS was achieved or maintained in 40 of 46 patients (87%) who presented for follow up at 6-8 weeks, 25 of 28 (89%) at 3-4 months, 35 of 41 (85%) at 5-6 months, and 55 of 61 (90%) at 7-12 months after starting therapy. Six patients were later switched off of DRV/DTG to another combination, of whom only two required switch due to intolerance (rash in 1 and large pill size in 1).

    Conclusion: Our preliminary results suggest that darunavir/dolutegravir combination is a viable switch option in HIV patients with the majority of patients achieving or maintaining VLS at 1 year of follow up and only 2 patients required a regimen change due to intolerance.

    Alexandra Stang, MD, 2300 Beasley Drive Doctors Park 6A, East Carolina University, Brody School of Medicine., Greenville, NC, Tracy Perry, PharmD, Pharmacy, East Carolina University, Greenville, NC and Nada Fadul, MD, Internal Medicine, East Carolina University, Greenville, NC

    Disclosures:

    A. Stang, None

    T. Perry, None

    N. Fadul, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.