Evidence map›Paper›PMID 36992471›Full record

ArticleViruses2023

Efficacy of Dolutegravir versus Darunavir in Antiretroviral First-Line Regimens According to Resistance Mutations and Viral Subtype.

Pierluigi Francesco Salvo, Damiano Farinacci, Arturo Ciccullo, Vanni Borghi, Stefano Rusconi, Annalisa Saracino, William Gennari, Bianca Bruzzone, Ilaria Vicenti, Annapaola Callegaro and 4 more

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in Viruses, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 36% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Review
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

14 authors at 10 institutions in 1 country.

Pierluigi Francesco SalvoDipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.ORCID 0000-0001-7559-7364
Damiano FarinacciUOC Medicina Protetta-Malattie Infettive-ASL Viterbo, 0100 Viterbo, Italy.ORCID 0000-0001-9106-7742
Arturo CicculloMalattie Infettive, Ospedale San Salvatore, 67100 L'Aquila, Italy.
Vanni BorghiClinica delle Malattie Infettive e Tropicali dell'Università di Modena e Reggio Emilia, 41100 Modena, Italy.
Stefano RusconiUOC Malattie Infettive, Ospedale Civile di Legnano, ASST Ovest Milanese, 20025 Legnano, Italy.ORCID 0000-0002-0375-9990
Annalisa SaracinoClinica Malattie Infettive, Università degli Studi di Bari, 70121 Bari, Italy.
William GennariClinica delle Malattie Infettive e Tropicali dell'Università di Modena e Reggio Emilia, 41100 Modena, Italy.
Bianca BruzzoneHygiene Unit, Policlinico San Martino Hospital, 16126 Genoa, Italy.
Ilaria VicentiDepartment of Medical Biotechnologies, University of Siena, 53100 Siena, Italy.ORCID 0000-0002-4306-2960
Annapaola CallegaroMicrobiology and Virology Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy.
Antonio Di BiagioInfectious Diseases Clinic, Policlinico San Martino Hospital, Department of Health Sciences (DISSAL), University of Genoa, 16126 Genoa, Italy.ORCID 0000-0003-1436-5089
Maurizio ZazziDepartment of Medical Biotechnologies, University of Siena, 53100 Siena, Italy.ORCID 0000-0002-0344-6281
Simona Di GiambenedettoDipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Alberto BorghettiUOC Malattie Infettive, Fondazione Policlinico Universitario A.Gemelli IRCCS, 00168 Rome, Italy.
Ospedale Policlinico San Martino · ITUniversità Cattolica del Sacro Cuore · ITUniversity of Modena and Reggio Emilia · ITUniversity of Siena · ITAgostino Gemelli University Polyclinic · ITAzienda Ospedaliera Ospedale Civile di Legnano · ITAzienda Sanitaria Locale Viterbo · ITOspedale Papa Giovanni XXIII · ITSan Salvatore Hospital · ITUniversity of Bari Aldo Moro · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDolutegravir (DTG)-based first-line regimens have shown superior efficacy versus darunavir (DRV)-based ones in randomized trials. We compared these two strategies in clinical practice, particularly considering the role of pre-treatment drug resistance mutations (DRMs) and of the HIV-1 subtype. MATERIALS AND

methodsThe multicenter Antiretroviral Resistance Cohort Analysis (ARCA) database was queried to identify HIV-1-positive patients starting a first-line therapy with 2NRTIs plus either DTG or DRV between 2013 and 2019. Only adult (≥18 years) patients with a genotypic resistance test (GRT) prior to therapy and with HIV-1 RNA ≥1000 copies/mL were selected. Through multivariable Cox regressions, we compared DTG- versus DRV-based regimens in the time to virological failure (VF) stratifying for pre-treatment DRMs and the viral subtype.

resultsA total of 649 patients was enrolled, with 359 (55.3%) and 290 (44.7) starting DRV and DTG, respectively. In 11 months of median follow-up time, there were 41 VFs (8.4 in 100 patient-years follow-up, PYFU) and 15 VFs (5.3 per 100 PYFU) in the DRV and DTG groups, respectively. Compared with a fully active DTG-based regimen, the risk of VF was higher with DRV (aHR 2.33;

conclusionsIn line with randomized trials, DTG-based first-line regimens showed an overall superior efficacy compared with DRV-based regimens. GRT may still play a role in identifying patients more at risk of VF and in guiding the choice of an antiretroviral backbone.

Indexed as

Anti-HIV AgentsHIV InfectionsAdultAnti-Retroviral AgentsDarunavirDolutegravirHumansInfantMutationRNAViral LoadAnti-HIV AgentsAnti-Retroviral AgentsDarunavirDolutegravirRNAantiretroviral therapyHIV drug resistanceHIV genotypic resistance testingHIV viral subtype

Identifiers

PMID36992471
PMCPMC10059835
OpenAlexW4327621548

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.