Long-Term Effectiveness and Tolerability of Dolutegravir/Lamivudine in Korea: A 3-Year Follow Up Study

Abstract

Background: Several studies have demonstrated the real-world efficacy and tolerability of dolutegravir/lamivudine (DTG/3TC). However, data from Asian countries-particularly regarding long-term use-remain limited. Materials and Methods: We conducted a retrospective cohort study of adult people living with human immunodeficiency viruses (PLWH) who were treated with DTG/3TC at a tertiary hospital in Korea. Individuals with a 36-month observation period from the initiation of DTG/3TC were included in the study, as well as those who switched to other regimens during follow-up were also analysed. Both treatment-naive individuals and those who switched to DTG/3TC from other regimens were included. Baseline characteristics, DTG/3TC maintenance rates, effectiveness, and changes in metabolic parameters over 36 months were evaluated. Results: Between July 2020 and April 2024, 305 PLWH received DTG/3TC, of whom 134 had an observation period of 36 months or longer. Most PLWH were male (94.0%), with a median age was 45.5 years. No participant switched from DTG/3TC to other regimens during the 36-month follow-up period. In the treatment-na & iuml;ve group, HIV RNA levels remained <50 copies/mL from 6 to 36 months after starting DTG/3TC treatment. In the switching group, 99.2% maintained <50 copies/mL at 36 months. Among the treatment-na & iuml;ve individuals, the CD4+ T cell count increased from a median of 494 cells/mu L at baseline to 795 cells/mu L at 36 months. During the 36-month follow-up, no significant changes were observed in lipid profiles or body weights in either the treatment-na & iuml;ve or switching groups, apart from an increase in high-density lipoprotein cholesterol in the switching group. Conclusion: DTG/3TC demonstrated sustained viral suppression and maintained CD4 count, with no significant adverse effects on lipid profiles or body weight.