Effectiveness of dolutegravir-based vs boosted darunavir-based first-line 3-drug regimens in people with HIV with advanced disease: a trial emulation.

• Tác giả: Andrea Antinori, Spinello Antinori, Sergio Lo Caputo, Stephen R Cole, Alessandro Cozzi-Lepri, Jessie K Edwards, Roberta Gagliardini, Andrea Giacomelli, Giulia Carla Marchetti, Valentina Mazzotta, Antonella d'Arminio Monforte, Cristina Mussini, Silvia Nozza, Carmela Pinnetti, Alessandro Raimondi, Alessandro Tavelli
• Ngôn ngữ: eng
• Ký hiệu phân loại: 297.1248 Sources of Islam
• Thông tin xuất bản: Canada : International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases , 2025
• Bộ sưu tập: NCBI
• ID: 713931

Tóm tắt

 BACKGROUND: No randomized comparisons exist between dolutegravir (DTG) and boosted-darunavir (DRV/b) for people initiating treatment with advanced HIV. METHODS: ART-naïve people with HIV (PWH) with CD4 <
 200 cells/mm RESULTS: A total of 1,323 advanced ART-naïve PWH were included, 895 starting DTG and 428 DRV/b. The unweighted risks of the composite endpoint by 48 months were 21.1% (95% CI: 18.1
 24.1%) for DTG versus 37.9% (95% CI: 32.7
 43.2%) for DRV/b (p<
 0.001). First-line treatment with DTG showed a lower risk of experiencing the composite endpoint than DRV/b (wHR of DTG vs DRV/b 0.47, 95% CI: 0.35
 0.64, p<
 0.001). CONCLUSION: Under the stated assumptions, this analysis indicates that in ART-naïve PWH with advanced disease, ART initiation with DTG vs. DRV/b-based regimens leads to a 50% reduction in the risk of AIDS/SNAE/death/VF/discontinuation. This observed difference is partly explained by discontinuation of the anchor drug.