More Evidence That Second-Line Dolutegravir Is Not Inferior to Ritonavir-Boosted Darunavir

In the NADIA (Nucleosides and Darunavir/Dolutegravir in Africa) trial, conducted in three sub-Saharan African countries, individuals who had virologic failure on a nonnucleoside reverse-transcriptase inhibitor (NNRTI)–based regimen were randomized to receive dolutegravir or ritonavir-boosted darunavir in combination with either tenofovir/lamivudine or zidovudine/lamivudine. The investigators previously reported on the proportion of patients with HIV-1 RNA <400 copies/mL at 48 weeks (the primary outcome; NEJM JW Infect Dis Sep 2021 and N Engl J Med 2021; 385:330). Now, they report the proportion of patients with such virologic suppression at 96 weeks.

Among 484 participants, rates of virologic suppression were:

• 90% in the dolutegravir group an…