Evidence map›Paper›PMID 33204746›Full record

ArticleOpen forum infectious diseases2020

Treatment Switch to Dolutegravir With 2 Nucleoside Reverse-Transcriptase Inhibitors (NRTI) in Comparison to Continuation With Protease Inhibitor/Ritonavir Among Patients With Human Immunodeficiency Virus at Risk for Prior NRTI Resistance: A Cohort Analysis of Real-World Data.

Mohamed N'dongo Sangaré, Jean-Guy Baril, Alexandra de Pokomandy, Steve Ferreira Guerra, Mabel Carabali, Claudie Laprise, Réjean Thomas, Marina Klein, Cécile Tremblay, Michel Roger and 10 more

Open access · goldAbstract read
In one paragraph

Article in Open forum infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.1field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 4 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 7 institutions in 1 country.

Mohamed N'dongo SangaréDepartment of Social and Preventive Medicine, Université de Montréal, Montreal, Québec, Canada.
Jean-Guy BarilClinique de Médecine Urbaine du Quartier Latin, Montreal, Québec, Canada.
Alexandra de PokomandyChronic Viral Illness Service, McGill University Health Centre, Montreal, Québec, Canada.
Steve Ferreira GuerraDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada.
Mabel CarabaliDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada.
Claudie LapriseDivision of Oral Health and Society, McGill University, Montreal, Québec, Canada.
Réjean ThomasClinique Médicale L'Actuel, Montreal, Québec, Canada.
Marina KleinChronic Viral Illness Service, McGill University Health Centre, Montreal, Québec, Canada.
Cécile TremblayFaculty of Medicine, Université de Montréal Montreal, Québec, Canada.
Michel RogerFaculty of Medicine, Université de Montréal Montreal, Québec, Canada.
Costa PexosChronic Viral Illness Service, McGill University Health Centre, Montreal, Québec, Canada.
Zoë R GreenwaldClinique Médicale L'Actuel, Montreal, Québec, Canada.
Nima MachoufClinique de Médecine Urbaine du Quartier Latin, Montreal, Québec, Canada.
Madeleine DurandDepartment of Microbiology, Infectious Diseases and Immunology, Université de Montréal, Montreal, Québec, Canada.
Isabelle HardyFaculty of Medicine, Université de Montréal Montreal, Québec, Canada.
Mamadou DakouoDepartment of Social and Preventive Medicine, Université de Montréal, Montreal, Québec, Canada.
Andrea TrevisanDepartment of Social and Preventive Medicine, Université de Montréal, Montreal, Québec, Canada.
Louise LaporteSainte Justine University Hospital Center, Montreal, Québec, Canada.
Mireille E SchnitzerDepartment of Social and Preventive Medicine, Université de Montréal, Montreal, Québec, Canada.
Helen TrottierDepartment of Social and Preventive Medicine, Université de Montréal, Montreal, Québec, Canada.
McGill University · CACentre Hospitalier Universitaire Sainte-Justine · CAUniversité de Montréal · CACentre Hospitalier de l’Université de Montréal · CAMcGill University Health Centre · CAPublic Health Ontario · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSwitching antiretroviral regimens when human immunodeficiency virus (HIV) viremia is controlled for a new regimen is challenging when there is the potential for prior nucleoside reverse-transcriptase inhibitor (NRTI) resistance. The objective was to study virologic outcomes after switching to dolutegravir compared with remaining on a boosted protease inhibitor (protease inhibitor/ritonavir [PI/r]) regimen in people with HIV (PWH) with prior documented virologic failure and/or exposure to mono/dual NRTIs.

methodsWe used the Quebec HIV Cohort including 10 219 PWH whose data were collected at 4 sites in Montreal, Canada. We included all PWH with documented virologic failure or exposure to mono/dual NRTI therapy who were virologically suppressed on a PI/r-based regimen for at least 6 months on or after January 1, 2014 (n = 532). A marginal structural Cox model analysis was used to estimate the effect of the switch to dolutegravir on virologic outcome compared with remaining on PI/r. The outcome was defined as 2 consecutive viral loads (VLs) >50 copies/mL or 1 VL >50 copies/mL if it occurred at the last VL available.

resultsAmong 532 eligible participants, 216 (40.6%) had their regimen switched to dolutegravir with 2 NRTIs, whereas 316 (59.4%) remained on the PI/r with 2 NRTIs. The weighted hazard ratio for the effect of dolutegravir switch on virologic failure compared with patients whose regimen remained on PI/r was 0.57 (95% confidence interval, 0.21-1.52).

conclusionsWe did not find evidence of an increased risk for virologic failure after switching to dolutegravir from PI/r among patients with previous virologic failure or prior exposure to mono/dual NRTI.

Indexed as

antiretroviral regimen (ART)dolutegravir switchpreviously documented virologic failure and prior exposure to mono/dual NRTI combination antiretroviral therapyprotease inhibitor/ritonavir (PI/r)

Identifiers

PMID33204746
PMCPMC7654378
OpenAlexW3083718901

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.