Dolutegravir and Darunavir combined with NRTIs are equally effective in treating HIV

Dolutegravir or Darunavir combined with NRTIs equally effective in treating HIV

According to a study published in the New England Journal of Medicine, dolutegravir and darunavir were equally effective in treating HIV - including in patients with high resistance - when combined with NRTIs. Additionally, trials have shown that tenofovir is non-inferior to zidovudine as a second-line therapy.

The research

An open-label, noninferiority trial, was conducted. 464 people living with HIV, whose first line therapy was failing (HIV viral load >1000 copies/ml), were recruited to the trial. The average age of participants was 34 years and 61% were women. 51% of participants had a CD4 count below 200, and 28% had a viral load of 100,000 copies/ml or higher.

52% of participants had medium or high tenofovir (TDF) resistance, and 92% had lamivudine (3TC) resistance.

Participants were randomly assigned either dolutegravir (DTG) or ritonavir-boosted darunavir (DRV/r) and to receive either TDF or zidovudine (ZDV) - all participants received 3TC.

The primary outcome the researchers were looking for was a viral load of less than 400 copies/ml by week 48.

The results

90% of participants (212/235) in the DTG group and 92% (210/229) in the DRV/r group received a viral load of less than 400 copies/ml at week 48.

When comparing the NRTIs, 92% of participants (215/233) in the TDF group and 90 (207/231) in the ZDV group also reached a viral load of less than 400 copies/ml at week 48.

Adverse effects did not differ substantially between the groups or comparisons.