Switching to Abacavir/Dolutegravir/Lamivudine (Triumeq) Maintains Undetectable Viral Load
October 13, 2015
Both ICAAC and IDWeek (formerly IDSA) are now over, IDWeek ending this past Sunday.
These are the two large Infectious Diseases scientific meetings that take place each year in the Fall. They've been battling it out for years for attendance, but it looks like finally IDWeek (formerly IDSA) has won the Fall slot -- ICAAC is moving next year to the Spring, where I assume it will stay.
Regardless of which meeting one attends, or when they happen, a common complaint heard from HIV-specialist types goes like this:
Well, it's not like CROI -- hardly anything here new and important.
Well, of course it's not like CROI -- that's a whole meeting devoted to HIV research, both clinical and basic. It's unreasonable to expect there will be anywhere near the number of oral sessions, posters, and plenaries on HIV at non-CROI meetings because, obviously, ICAAC and IDWeek have to represent the full breadth of material in the field.
But there usually is some good stuff, studies that could significantly impact clinical practice. Here's the most important HIV study from ICAAC, and soon the notable ones from IDWeek.
At the end of 24 weeks, treatment success (HIV RNA < 50 copies by "snapshot", meaning also still in study) was observed in 85% and 88% of subjects in the switch vs continue current ART arms respectively:
A few comments on these results, which were both reassuring and disappointing at the same time:
An interesting irony is that the SINGLE study -- which emphatically put DTG on the map demonstrated superiority of ABC/3TC + DTG over TDF/FTC/EFV, results driven by better tolerability. Think about that one, and what it says about efavirenz.
Take-home message? Switching to ABC/3TC/DTG will mostly be successful (especially virologically), but a small fraction might have side effects that makes them prefer what they've already been on.
Anyway, that's the most important HIV study at ICAAC. Coming soon, the most important one (or two or three, haven't decided yet) at IDWeek.
Paul Sax is Clinical Director of Infectious Diseases at Brigham and Women's Hospital. His blog HIV and ID Observations is part of Journal Watch, where he is Editor-in-Chief of Journal Watch AIDS Clinical Care.
This article was provided by NEJM Journal Watch. It is a part of the publication The 55th Interscience Conference on Antimicrobial Agents and Chemotherapy. NEJM Journal Watch is a publication of the Massachusetts Medical Society.
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