Real-life use of Doravirine in treatment-experienced people living with HIV: A multicenter Italian study. Issue 30 (29th July 2022)

• Record Type: Journal Article
• Authors: Mazzitelli, Maria; Antoni, Melania Degli; Castelli, Francesco; Ripamonti, Diego; Zuglian, Gianluca; Lapadula, Giuseppe; Fabbiani, Massimiliano; Ferraresi, Alice; Putaggio, Cristina; Cattelan, Anna Maria; Quiros-Roldan, Eugenia
• Is Part Of: Medicine. Volume 101:Issue 30(2022)
• Page Start: e29855
• Publication Date: 2022-07-29
• Subjects: doravirine -- dyslipidemia -- HIV -- PLWH -- real-life -- switch; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000029855
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Use of doravirine (DOR), a new nonnucleoside reverse-transcriptase inhibitors recently approved for HIV treatment, is still unclear in clinical practice and real-life data are scarce. We retrospectively investigated the rationale for switching people with HIV to DOR-containing/-based regimens in a real-life cohort. Among 132 patients (68.9% males, median age 56 years), the main reasons to start DOR were prevention of toxicities (39.4%) and dyslipidemia (18.2%). DOR was combined with integrase inhibitors in 40.9% cases, and in 25.7% of patients, DOR was prescribed without availability of a genotypic resistance test. Twenty-four weeks after the switch to DOR-containing/-based regimens, no significant changes in CD4+ T-cell count, CD4/CD8 ratio, detectable HIV-RNA, serum creatinine levels, and body weight were detected. By contrast, a significant reduction in lipids (both cholesterol and triglycerides) was observed in 52 patients for whom a follow-up assessment was available ( P = .008 and .01, respectively). Our data confirmed that switching to DOR-containing/-based regimens may have a favorable impact on lipid profile and a neutral impact on weight gain. However, more data are needed to support its use in patients who do not have a genotypic test available or have an extensive nonnucleoside reverse-transcriptase inhibitors-associated resistance, as well as its use in a dual regimen, especially in combination with second-generation integrase inhibitors.