Dolutegravir Monotherapy: One Is Not Enough

Accumulating data indicate that some two-drug antiretroviral regimens are effective in treating HIV. Monotherapy, however, has been dogged by concerns regarding inadequate potency and emergence of resistance. Now, investigators in France have evaluated whether monotherapy with dolutegravir, which has a high barrier to resistance, maintained HIV control in people who already had virologic suppression.

A total of 158 people on three-drug antiretroviral therapy (ART) with HIV RNA <50 copies/mL were randomized to continue their regimen or switch to dolutegravir monotherapy. At week 24, rates of virologic suppression were similar in both groups, but by week 48, the monotherapy group had a higher rate of virologic failure than the three-drug group…