Affiliation:
1. Chest Hospital of Guangxi Zhuang Autonomous Region Liuzhou China
Abstract
AbstractObjectivesDolutegravir + lamivudine (DTG + 3TC) is a first‐line regimen for people with HIV. However, there are still concerns about its efficacy in people with tuberculosis (TB)/HIV due to the lack of available evidence and drug–drug interaction with rifampicin.MethodsA single‐centre retrospective observational case series was conducted in Guangxi Zhuang Autonomous Region, China. We included all people with TB/HIV on combined use of once‐daily (q.d.) dosing DTG + 3TC and rifampicin (RIF)‐containing anti‐TB regimens between 2020 and 2022. HIV‐RNA, CD4 cell counts were collected and analysed.ResultsIn all, 21 people with HIV (PWH) were included in this study. All the PWH were treatment‐naïve and told to take DTG + 3TC q.d. with food. The median age was 53 years, and 71.43% were male. A total of 71.43% PWH had baseline viral load (VL) > 100 000 copies/mL, and 33.33% had baseline VL greater than 500 000 copies/mL. Only one PWH had CD4 cell count greater than 200 cells/μL, and the median CD4 count was 20 cells/μL. A total of 16 PWH started DTG + 3TC after initiation of the RIF‐based anti‐TB regimen, and the other five PWH initiated DTG + 3TC before the treatment of TB. All the PWH had at least 24 weeks of follow‐up visits and all of the TB treatments were successful. A total of 20 PWH (95.24%) achieved viral suppression (VL <50 copies/mL). All detected viral loads between weeks 24 and 48 were less than 200 copies/mL. Among the PWH who started DTG + 3TC after the initiation of RIF‐based anti‐TB regimen, all achieved viral suppression by week 24 except the non‐suppressed PWH. CD4 counts were greatly improved after antiretroviral treatment: the median CD4 counts were raised from 20 to 171 cells/μL at week 48. No serious adverse events were reported.ConclusionsThis case series preliminarily validates the efficacy of DTG + 3TC q.d. with food when combined with RIF‐based anti‐TB regimens in people with TB/HIV.