Treatment of HIV/AIDS with “Dolutegravir-Based Regimen” Antiretroviral Therapy
Keywords:
Dolutegravir, Integrase strand transfer inhibitor, HIV/AIDSAbstract
Current guidelines recommend dolutegravir (DTG) as the first-line antiretroviral regimen in the treatment of HIV/AIDS. DTG is a second-generation integrase strand transfer inhibitor that has demonstrated high potency, high genetic barrier to resistance, tolerability, minimal drug-drug interactions, and convenience. DTG is also used in a 2-drug regimen among treatmentnaive individuals, as well as for switching regimens in virally suppressed HIV/AIDS patients with impaired renal function. However, DTG also has a few considerations. Firstly, DTG has revealed drug-drug interactions with antacids containing aluminum or magnesium, as well as with food or medications containing calcium, iron, or multivitamins, and metformin. Secondly, DTG can increase serum creatinine levels without impacting glomerular filtration rate by inhibiting tubular creatinine secretion. Finally, there was previously a recommendation against using DTG in pregnant women due to concerns about an increased risk of neural tube defects. However, it has been found that the incidence does not differ significantly from the general population. Therefore, almost all current guidelines permit the use of DTG in reproductive-age women and during pregnancy.
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