EACS2023: 766 Switching to dolutegravir/lamivudine in real life: three years results from a small HIV clinic cohort G. Battagin , F. Cioli Puviani , F. Rigo , S. Nicolé , S. Parisi , V. Manfrin San Bortolo Hospital, Infectious Disease, Vicenza, Italy, University of Verona, Infectious Disease, Verona, Italy, University of Padova, Microbiology, Padova, Italy General data Abstract category: Antiretroviral therapy – observational studies Abstract body Purpose: Dolutegravir (DTG) plus lamivudine (3TC) has shown excellent results in clinical trials as treatment simplification strategy in virologically suppressed (VS) individuals . Current EACS Guidelines reserve this option for patients VS if there is no historical resistance and HBV immunity . Few studies describe the use of this therapy in routine clinical practice in patients with M184 and without genotypic resistance test at diagnosis, especially outside academic hospitals . Method: This was an observational, retrospective study. It included a little number treatment-experienced HIV patients switched to DTG+3TC from August 2018 to March 2020. Our aim is to describe clinical and virological characteristics of this cohort and assess rate of virological suppression (VS) after 144 weeks of treatment (W144). Results: A total of 61 patients were included: 16 (26%) experienced previous AIDS defining events, 33 (54%) had CD4 nadir < 200 cells/μl and 28 (46%) presented at least one prior viral failure. 11 (18%) patients were anti-HBc positive and HBsAg negative. At W144, we reported only 2 virological failures (VFs), both without new mutations in genotyping resistance tests after VFs. For 7 patients, we documented history M184V mutation resistance. This mutation was detected in genotyping resistance test in past failure episodes, but for 5 of them we performed a BPMCs genotyping test showing no more M184V mutation: 3 out of these 7 patients completed W144 follow up and maintained VS (for the other 4 patients 1 died, 1 lost to follow up, 2 switched for weight gain). 1 2 1 1 3 1 1 2 3 1 2 3
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