¿La combinación dolutegravir y rifampicina en los pacientes no incluidos en los ensayos clínicos es también eficaz y segura en el binomio VIH-infección micobacteriana? Casos de la práctica clínica

Abstract

Introduction

Mycobacterial infections and HIV is still a relevant topic. Rifampicin complicates antiretroviral drugs management, influencing the prognostic of both conditions. Dolutegravir is a first option drug, but rifampicin diminishes its levels. Doubling dolutegravir doses until two weeks after completing rifampicin treatment has good results. Our goal is to confirm in our daily practice the efficacy and safety of this scheme.

Methods

Eighteen HIV patients were included with mycobacterial infections. Rifampicin was administered with dolutegravir twice a day as commented. Viral suppression and mycobacterial curation were analyzed until the end of the follow-up.

Results

Thirteen from 18 were men, 46 years (interquartile range [IQR]: 38–49), diagnosed of HIV or treated since 1.8 years (IQR: 0.1–12), presenting mainly disseminated mycobacterial infections (11 of 18 cases). From which completed follow-up, 91.6% achieved mycobacterial curation (11 of 12) and 92.9% viral load suppression (13 of 14).

Conclusion

The treatment of rifampicin with adjusted dolutegravir doses seems to be a proper combination even in severe immunosuppresed population.