Adults with HIV who made the switch to dolutegravir/lamivudine (DTG/3TC) maintained similar virologic efficacy and persistence compared with those who continued bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF), according to an observational extension phase of the DYAD study. However, drug-related adverse events (AEs) and discontinuations were higher with DTG/3TC.
At IDWeek 2025, Charlotte-Paige M. Rolle, MD, MPH, of the Orlando Immunology Center and Emory Rollins School of Public Health, presented the real-world findings during a poster session.
Rolle and colleagues evaluated efficacy, safety, and persistence among virologically suppressed adults. The open-label DYAD trial randomly selected 222 enrolled patients with HIV-1 RNA level of less than 50 copies/mL and no prior virologic failure to switch to DTG/3TC (n=149) versus continuing B/F/TAF (n=73). Results demonstrated that switching to DTG/3TC worked just as effectively as staying on B/F/TAF for people whose HIV was already under control after 48 weeks.
At the end of the study, patients were asked for consent to data collection from medical records through Week 96 and Week 144 to be used for the extension phase, and 124 on DTG/3TC and 63 on B/F/TAF agreed.
At Week 96, three patients on DTG/3TC and one on B/F/TAF had HIV-1 RNA levels of about 50 copies/mL. Moreover, HIV-1 RNA levels of less than 50 copies/mL were seen in 99 patients on DTG/3TC compared with 52 on B/F/TAF.
In addition, confirmed virologic failure criteria were met by 13 patients on DTG/3TC and six on B/F/TAF, and resistance was observed in 2 and 1 patients, respectively.
Medication persistence was similar between treatment groups (DTG/3TC: 75%; B/F/TAF: 80%).
Patients in both groups experienced AEs, with more occurring in the DTG/3TC group. AEs were the main reason for DTG/3TC discontinuation versus consent withdrawal in the B/F/TAF group. Compared with B/F/TAF, more drug-related AEs were seen in the DTG/3TC group through Week 96 (5% vs 28%, respectively).
Reference
Rolle C-P M, et al. IDWeek 2025. P-348
