Johannes C Botha, Kim Steegen, Mariam Edoo, Jeremy Nel, Gert U van Zyl
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Low-level viraemia despite emergence of dolutegravir-resistant variants.
Dolutegravir (DTG), an integrase strand transfer inhibitor (INSTI)-based HIV-1 therapy, is widely recommended in first-line and second-line regimens.1,2 Integrase strand transfer inhibitor resistance mutations associated with DTG-containing regimens have been well described, most often occurring after DTG monotherapy or in INSTI-experienced patients.3Although rare, emergence of these mutations has also been described in patients on DTG-containing triple-drug regimens4 and INSTInaïve patients.5,6 The R263K mutation is commonly associated with the emergence of DTG resistance but reduces viral fitness and DNA integration.7,8 Here we describe a case of very slow viral decline (~42 months) in a treatment-experienced, INSTI-naïve patient on a DTG-based triple therapy regimen.
期刊介绍:
The Southern African Journal of HIV Medicine is focused on HIV/AIDS treatment, prevention and related topics relevant to clinical and public health practice. The purpose of the journal is to disseminate original research results and to support high-level learning related to HIV Medicine. It publishes original research articles, editorials, case reports/case series, reviews of state-of-the-art clinical practice, and correspondence.