Changes in Inflammatory and Atherogenesis Biomarkers With the 2-Drug Regimen Dolutegravir Plus Lamivudine in Antiretroviral Therapy–Experienced, Virologically Suppressed People With HIV-1: A Systematic Literature Review. (10th February 2022)

• Record Type: Journal Article
• Authors: Llibre, Josep M; Cahn, Pedro E; Lo, Janet; Barber, Tristan J; Mussini, Cristina; van Welzen, Berend J; Hernandez, Beatriz; Donovan, Cynthia; Kisare, Michelle; Sithamparanathan, Myooran; van Wyk, Jean
• Is Part Of: Open forum infectious diseases. Volume 9:Number 4(2022)
• Publication Date: 2022-02-10
• Subjects: dolutegravir plus lamivudine -- 2-drug regimen -- HIV-1 -- inflammation; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofac068
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: The 2-drug regimen dolutegravir plus lamivudine has demonstrated long-term noninferior efficacy vs 3-/4-drug regimens (3/4DRs) in phase 3 trials. This systematic literature review summarizes clinical trial and real-world evidence evaluating impact of dolutegravir plus lamivudine on inflammatory and atherogenesis biomarkers in people with human immunodeficiency virus type 1 (PWH). Methods: Using Ovid MEDLINE, Embase, PubMed, and Cochrane library databases and conference proceedings, we searched for studies published from 1 January 2013 to 14 July 2021, reporting changes in inflammatory and atherogenesis biomarkers with dolutegravir plus lamivudine in antiretroviral therapy–experienced, virologically suppressed PWH aged ≥18 years. Results: Four records representing 2 randomized controlled trials (RCTs) and 6 records of real-world evidence met eligibility criteria. All real-world studies evaluated CD4 + /CD8 + ratio, while only 1 assessed inflammatory biomarkers. Across both RCTs, no consistent pattern of change in biomarkers was observed between dolutegravir/lamivudine and 3/4DR comparators. There were significant changes in soluble CD14 favoring dolutegravir/lamivudine in TANGO at weeks 48 and 144 and SALSA at week 48, and in interleukin-6 favoring the control group in TANGO at weeks 48 and 144. In the real-world study evaluating inflammatory biomarkers, median soluble CD14 significantly decreased 48 weeks postswitch to dolutegravir plus lamivudine ( P < .001), while other biomarkers remained stable. In all 6 real-world studies, increases in CD4 + /CD8 + ratio were reported after switch to dolutegravir plus lamivudine (follow-up, 12–60 months). Conclusions: Results show that dolutegravir plus lamivudine has a comparable impact on inflammatory and atherogenesis biomarkers vs 3/4DRs, with no consistent pattern of change after switch in virologically suppressed PWH. Abstract : Results from this systematic literature review show that the 2-drug regimen of dolutegravir plus lamivudine has a comparable impact on inflammatory and atherogenesis biomarkers vs 3- or 4-drug regimen comparators, with no consistent reproducible pattern of change.