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Switch to dolutegravir and unboosted atazanavir in HIV-1 infected patients with undetectable viral load and long exposure to antiretroviral therapy

Castagna, Antonellaa; Rusconi, Stefanob; Gulminetti, Robertoc; Bonora, Stefanod; Mazzola, Giovannie; Quiros-Roldan, Maria E.f; De Socio, Giuseppe V.g; Ladisa, Nicolettah; Carosella, Sinibaldoi; Cattelan, Annamariaj; Di Giambenedetto, Simonak; Mena, Mauriziol; Poli, Andreaa; Galli, Lauraa; Riva, Agostinob on behalf of DAU Study Group

doi: 10.1097/QAD.0000000000002188

We evaluated the efficacy and safety of a two-drug regimen including dolutegravir (DTG) and unboosted atazanavir (uATV) in 151 HIV-1 infected patients with HIV-RNA of more than 50 copies/ml. During a median follow-up of 62 (42–97) weeks, two virological failures (1%) and 13 treatment discontinuations (9%) occurred; the 48-week probability of virological failure was 0.8% (95% confidence interval 0.2–5.6%). Switch to DTG + uATV may represent a boosting and transcriptase reverse inhibitors sparing otion in individuals with long exposure to antiretroviral therapy and risk of cardiovascular disease.

aInfectious Diseases Department, IRCCS San Raffaele Scientific Institute & Vita-Salute University

bInfectious Diseases Unit, DIBIC Luigi Sacco, University of Milan, Milan

cInfectious Diseases Unit, Fondazione IRCCS Policlinico San Matteo, Pavia

dInfectious Diseases Unit, Amedeo di Savoia Hospital, University of Turin, Turin

eInfectious Diseases Unit, Paolo Giaccone/Azienda Ospedaliera Universitaria Policlinico, Palermo

fInfectious Diseases Unit, Spedali Civili General Hospital, Brescia

gInfectious Diseases Unit, Azienda Ospedaliero-Universitaria di Perugia, Perugia

hInfectious Diseases Unit, Azienda Universitaria Ospedaliera Consorziale – Policlinico di Bari, Bari

iInfectious Diseases Unit, Amedeo di Savoia Hospital, Turin

jInfectious Diseases Unit, Azienda Ospedaliera-Universitaria di Padova, Padova

kInfectious Diseases Unit, Catholic University of Sacred Heart, Rome

lInfectious Diseases Unit, Azienda Ospedaliera di Legnano, ASST Ovest Milanese, Legnano, Italy.

Correspondence to Antonella Castagna, MD, Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127 Milan, Italy. Tel: +39 226437934; fax: +39 226437903; e-mail:

Received 13 December, 2018

Revised 23 January, 2019

Accepted 24 January, 2019

Copyright © 2019 Wolters Kluwer Health, Inc.