EACS2023: 765 Assessing the effectiveness and safety of lamivudine/dolutegravir versus bictegravir/emtricitabine/tenofovir alafenamide fumarate in adults living with human immunodeficiency virus: one retrospective observational cohort study C.-Y. Cheng , S.-Y. Ku , H.-T. Hsieh , M.-H. Lin , S.-Y. Chang , N.-L. Sun , Y.-C. Lin , C.-P. Chen , S.-H. Cheng Taoyuan General Hospital, Department of Infectious Diseases, Taoyuan City, Taiwan, Taoyuan General Hospital, Department of Nursing, Taoyuan City, Taiwan General data Abstract category: Antiretroviral therapy – observational studies Abstract body Purpose: The 2-drug regimen dolutegravir/lamivudine (DTG/3TC) is indicated for treatment-naive and suppressed adults with human immunodeficiency virus (HIV). In TANGO, switching to DTG/3TC demonstrated long-term noninferior efficacy vs continuing tenofovir alafenamide–based regimens in treatment-experienced adults with HIV-1. But there was few real world data in comparing the effectiveness and safety of bictegravir/emtricitabine/tenofovir alafenamide fumarate (BIC/FTC/TAF) and lamivudine/dolutegravir (DTG/3TC) in Asia; hence, we present the outcome in HAART experienced patients. Method: This was a retrospective observational study conducted at one HIV-care designed hospital since March 2019 to October 2022. Among negative HBsAg status and no detected resistance-associated mutations (RAM) of DTG and 3TC HIVinfected patients, DTG/3TC would be switched, and BIC/FTC/TAF would be decided by physicians or patients without specific limitation. The information on demographics, clinical characteristics, laboratory testing, HIV viral loads and lipid profiles were collected and analyzed. The primary outcome of study was proportion of participants with HIV-1 RNA <50 copies/mL at week 48 in these two groups ; Snapshot, per-protocol–exposed population. Results: Overall, 1044 patients were included to switch to DTG/3TC (n=508) or BIC/FTC/TAF (n=536). (Table 1) Table 1: The characteristics of HIV-infected and experienced patients who switched to DTG/3TC or BIC/FTC/TAF. Total patient (n= 1044) DTG/3TC (n=508) BID/FTC/TAF (n=536) p age, y/o ± SD 39.7 ± 10.1 39.9 ± 10.4 39.6 ± 9.8 0.053 male, n (%) 971 (93) 477 (93.9) 494 (92.2) 0.27 risks of infected HIV 0.003 MSM, n (%) 734 (70.3) 368 (72.4) 366 (68.3) IDU, n (%) 191 (18.3) 85 (16.7) 106 (19.8) Heterosex, n (%) 91 (8.7) 50 (9.8) 41 (7.6) HIV-1 RNA before switch, copies/mL <50 copies/mL, n (%) 923 (88.4) 469 (92.3) 454 (84.7) <0.001 >10,000 copies/mL, n (%) 43 (4.1) 12 (2.4) 31 (5.8) 0.005 >100,000 copies/mL, n (%) 18 (1.7) 5 (0.1) 13 (2.4) 0.07 HAART before switch <0.001 MTR, n (%) 63 (6) 10 (2) 53 (9.9) TDF/FTC/EFV, n (%) 40 (3.8) 15 (3) 25 (4.7) BIC/FTC/TAF, n(%) 11 (1.1) 11 (2.2) 0 (0) TDF/FTC/RPV, n (%) 17 (1.6) 0 (0) 17 (3.2) TAF/FTC/EVG/c, n (%) 412 (39.5) 6 (1.2) 406 (75.7) DTG/RPV, n (%) 85 (8.1) 85 (16.7) 0 (0) ABC/3TC/DTG, n (%) 392 (37.5) 357 (70.3) 35 (6.5) TAF/FTC/RPV, n (%) 11 (1.1) 11 (2.2) 0 (0) Abbreviations: SD: standard deviation; MSM: men who have sex with men; IDU: injection drug users; MTR: multiple tablet regimen; ABC:abacavir; 3TC: lamivudine; DTG:dolutegravir; RPV:rilpivirin; TDF:tenofovir; EFV:efavirenz; TAF:tenofovir alafenamide; BIC:bictegravir; EVG/c:Elvitegravir/cobicistat At week 48, 491(96.7%) of patients in the dovato group and 472(88.1%) of patients in the biktarvy group had HIV-1 RNA <50 copies/mL (Snapshot, p<0.001, adjusted difference, 8.6%; 95% CI, 8.2%, 8.8%), and subgroups analysis was showed in Figure 1. Statistical analysis revealed no significant differences in total cholesterol (CHOL), HDL, LDL, triglyceride (TG) and CHOL/HDL ratio between the two groups. ( Figure 2) Conclusions: The study showed that DTG/3TC was significant effective and well tolerated regimen in HIV experienced patients, and which supports that it is one of considerable switch regimens, especially for virologically suppressed patients. General conditions 1. I confirm that I previewed this abstract and that all information is correct. I accept that the content of this abstract cannot be modified or corrected after the submission deadline and I am aware that it will be published exactly as submitted.: Yes 2. I confirm that the submission of the abstract constitutes my consent to publication (e.g. conference website, programmes, other promotions, etc.). : Yes 3. I herewith confirm that the contact details saved in this system are those of the corresponding author, who will be notified about the status of the abstract. The corresponding author is responsible for informing the other authors about the status of the abstract.: Yes 4. I agree that all data provided may be used (saved, stored, processed, transmitted and deleted) in compliance with the privacy policy to provide the services described.: Yes 1 2 1 2 2 2 1 1 1 1 2 151
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