ABSTRACT
Antiretroviral regimens for human immunodeficiency virus (HIV) infection have continuously evolved; however, antiretrovirals can cause severe adverse reactions. Two-drug regimen therapy can decrease lifetime cumulative drug exposure and long-term toxicities associated with multiple antiretrovirals. The preferred 2-drug regimen constitutes dolutegravir (DTG) and lamivudine (3TC). This study determined the rate of virological suppression and incidence of adverse events at week 48 in treatment-naïve people living with HIV initiated on DTGâ +â 3TC. This was a single-center, retrospective, observational study. Treatment-naïve people aged ≥18 years who received at least 1 DTGâ +â 3TC dose between May 2020 and May 2022 were included. Eighty-nine people living with HIV were enrolled. Twenty-five (28.1%) patients with a DTGâ +â 3TC regimen at baseline were analyzed because of comorbidities, and 48% because of concomitant tuberculosis (TB). Viral suppression at 48 weeks was achieved in 91.67% of patients, and TB was well controlled. At week 48, 84 (94.38%) patients had viral loadsâ <â 50 copies/mL, and 21 (91.31%) of the 23 participants with a baseline HIV-1-RNA levelâ ≥â 1â ×â 105 copies/mL achieved virological success. Fifteen (88.23%) of the 17 participants with a baseline CD4â +â cell count of <200 cells/µL achieved virological suppression. The median CD4â +â cell count change from baseline was 539.5 cells/µL. No significant changes in triglycerides, low-density lipoprotein cholesterol, weight, or creatinine were observed from baseline to 48 weeks. One patient had severe insomnia at 4 weeks. Our findings support the real-world effectiveness and low metabolic impact of DTGâ +â 3TC. Using DTGâ +â 3TC in patients coinfected with TB and HIV has favorable therapeutic outcomes.
Subject(s)
Anti-HIV Agents , Drug Therapy, Combination , HIV Infections , Heterocyclic Compounds, 3-Ring , Lamivudine , Oxazines , Piperazines , Pyridones , Tuberculosis , Humans , Pyridones/administration & dosage , Pyridones/therapeutic use , Pyridones/adverse effects , Lamivudine/therapeutic use , Lamivudine/administration & dosage , Lamivudine/adverse effects , Heterocyclic Compounds, 3-Ring/therapeutic use , Heterocyclic Compounds, 3-Ring/adverse effects , Heterocyclic Compounds, 3-Ring/administration & dosage , Female , HIV Infections/drug therapy , HIV Infections/complications , Male , Retrospective Studies , Adult , Piperazines/therapeutic use , Piperazines/administration & dosage , Piperazines/adverse effects , China , Middle Aged , Tuberculosis/drug therapy , Tuberculosis/complications , Anti-HIV Agents/therapeutic use , Anti-HIV Agents/adverse effects , Anti-HIV Agents/administration & dosage , Viral Load/drug effects , Coinfection/drug therapy , Treatment Outcome , CD4 Lymphocyte CountABSTRACT
BACKGROUND: We report a mononucleosis-like illnesses case due to co-infection with severe fever with thrombocytopenia syndrome virus (SFTSV) and spotted fever group rickettsia (SFGR), which to the best of our knowledge, has never been reported . CASE PRESENTATION: A 64-year-old male with an 11-day history of fever, sore throat, malaise, nausea, and non-pruritic rash was admitted to our emergency department. Prior to admission, he was bitten by ticks. Laboratory tests revealed a white blood cell count of 24,460 cells/µL with 25% atypical lymphocytes and 20% mononucleosis, thrombocytopenia. Test results were positive for SFTSV RNA, SFTSV-specific IgM antibody, and SFGR-specific IgM antibody. He was diagnosed with mononucleosis-like illnesses due to co-infection with SFTSV and SFGR. After administration of doxycycline, he recovered completely. CONCLUSIONS: The clinical presentation may be atypical in co-infection with SFTSV and SFGR. This finding highlighted the importance of considering SFGR infection, as well as a SFSTV and SFGR co-infection for the differential diagnosis of patients bitten by ticks in SFTSV-endemic areas.
