Dolutegravir had substantial activity against raltegravir- and elvitegravir-resistant HIV, particularly if key integrase gene mutations were not present.
Resistance to the HIV integrase strand transfer inhibitor (INSTI) raltegravir generally confers cross-resistance to elvitegravir, and vice versa. The effect of raltegravir and elvitegravir resistance on the activity of the newest INSTI, dolutegravir, was recently assessed in VIKING-3, a manufacturer-sponsored, phase III, single-arm, open-label, multicenter trial. A 50-mg twice-daily dose of dolutegravir was used in this trial, based on results from VIKING-2, a phase IIB study in which virologic suppression rates in patients with raltegravir-resistant virus were higher with this dose of dolutegravir than with 50 mg once daily (NEJM JW AIDS Clin Care Jan 28 2013).
Treatment-experienced adults with HIV resistant to raltegravir, elvitegravir, or…
Reviewing Author
DisclosuresGrant/Research SupportNIH
Editorial BoardsUpToDate; ID Images (idimages.org); Infectious Diseases Society of America COVID-19 Treatment Guidelines; International Antiviral Society–USA (Guidelines Committee)
Leadership Positions in Professional SocietiesHIV Medicine Association; Infectious Diseases Society of America (Board of Directors)
DisclosuresGrant/Research SupportNIH
Editorial BoardsUpToDate; ID Images (idimages.org); Infectious Diseases Society of America COVID-19 Treatment Guidelines; International Antiviral Society–USA (Guidelines Committee)
Leadership Positions in Professional SocietiesHIV Medicine Association; Infectious Diseases Society of America (Board of Directors)