Effectiveness, Safety, and Costs of a Treatment Switch to Dolutegravir Plus Rilpivirine Dual Therapy in Treatment-Experienced HIV Patients

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Abstract
Background: Evidence about the use of dolutegravir (DTG) and rilpivirine (RPV) as an antiretroviral therapy (ART) in treatment-experienced patients is scarce. Objective: To explore the effectiveness, safety, and costs of switching to a DTG plus RPV regimen in this population. Methods: This observational, prospective study included all treatment-experienced patients who switched to DTG plus RPV between November 2014 and July 2016. Patients were excluded if resistance mutations to integrase inhibitors or RPV were found. The effectiveness endpoint was the proportion of patients who achieved virological suppression (viral load [VL] 90% increased from 65.6% to 93.8% (P = 0.004). The annual per-patient ART costs dropped by €665 (P = 0.265). Conclusions: Switching to DTG plus RPV seems to be an effective and safe strategy. Significant improvements in patients’ adherence and costs were achieved.

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