Background and Importance Doravirine is a non-competitive, non-nucleoside reverse transcriptase inhibitor (RTI), used in combination regimens with other antiretrovirals for the treatment of HIV-1 without evidence of resistance to non-nucleoside inhibitors.
Aim and Objectives To describe the clinical-epidemiological characteristics and the clinical and analytical evolution of DORA associated with (ABC/3TC), (DTG) and (RPV).
Material and Methods To assess the efficacy of DORA, clinical response was analysed through follow-up consultations and serological tests, measuring viral load (VL), CD4-T lymphocytes, liver profile, and renal function. Follow-up was performed at 2, 4 and 6 months from the start of treatment.
Results We followed up 36 patients (31 men), with a mean age of 53.8 years (26-64), 20 were being treated with (ABC/3TC+DORA), 9 with (RPV+DORA) and 7(DTG+DORA). 77% were smokers and 7 of them diagnosed with alcohol habit. At the beginning, 94.4% had undetectable viral load (VL<50 cop/ml), except for two that showed VL>10x6 cop/ml, probably due to non-compliance or abandonment of treatment. VL<50 cop/ml were observed during the study, except for those previously mentioned that achieved a maximum reduction of 110 and 150 cop/ml. All were classified in stages A2 and A3, except two of them classified as B3. The most common side effects were diarrhoea, nausea and/or vomiting, and mild headaches. Two of them reported myalgia, although we suspect it was unrelated to DORA, as they were treated with atorvastatin 80 mg/24h for hypercholesterolemia. The patients with (RPV+DORA) came from (ABC/3TC+DORA), who were replaced by RPV due to hypercholesterolemia, liver disorders or intake of PPIs or NSAIDs. The mean CD4-T lymphocyte count was 720/µL (262-1169/µL) and the mean creatinine was normal and between 0.9 and 1.1 mg/dl (laboratory range), except for two patients with 1.13 mg/dl and 1.29mg/dl.
Conclusion and Relevance Doravirine has been shown to be a safe and effective therapeutic alternative for HIV-1 infection, especially in patients with metabolic disorders or interactions with other drugs. The role of hospital pharmacists was to guarantee adherence to treatment and to document the most frequent side effects by reporting them to the Local HIV Commission.
References and/or Acknowledgements 1. Ficha técnica: https://cima.aemps.es/cima/pdfs/es/ft/1181332001/FT_1181332001.pdf
Thanks to Infectious disease Unit DORA: doravirine, RPV: rilpivirine, ABC/3TC: abacavir/lamivudine, DTG: dolutegravir, PPIs: proton-pump inhibitors, NSAIDs: non-steroidal anti-inflammatory drugs
Conflict of Interest No conflict of interest
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