Caracterização das trocas de Dolutegravir na terapia antirretroviral inicial

Abstract

DTG was the last drug from the INI class to be incorporated into the scope of the Unified Health System (SUS) for the therapeutic management of HIV infection. It has the advantages of high potency, high genetic barrier, administration in a single daily dose and few adverse events, ensuring longer lasting and safer antiretroviral regimens. Objective: To know the profile of patients who changed DTG from initial antiretroviral treatment, in Ceará, through the HSJ UDM. Methodology: A case-control study was carried out with patients who started antiretroviral therapy with DTG and had to change this drug (cases) and compared with patients who remained on DTG in the drug regimen (control) at the time of switching and after one year of said event. The research was carried out at Hospital São José de Infectious Diseases, between January 2017 and December 2018. Data were collected through patient records and computerized systems (SISCEL and SICLOM). Epidemiological and clinical variables (presence and/or emergence of co-infections, reason for replacing the DTG and clinical outcome) and nonspecific laboratory tests were collected, such as: SGOT, SPT, glucose, total cholesterol, creatinine, LT-CD4+ counts and viral load . In the statistical part, the Stata 13 program was used, to assess the differences between the case and control groups, the Mann Whitney test (quantitative variables) or Fisher's exact test (qualitative variables) was used, a value of p<0.05 was adopted for statistical significance. The project was approved by the ethics committee, with the number: 97053018.00000.5044. In total there were 45 patients in the case group and 90 in the control group. The mean age of patients was 32 years, with a predominance of males (76.3%), most residing in Fortaleza (56.3%), a small proportion required hospitalization (20%) and 98.5 had as initial regimen the drugs: TDF/3TC+DTG. The average number of days of use of the DTG before switching was 104.2 days and the main reason for switching was tuberculosis, with 32 individuals (71.11%). There was no statistical difference when comparing the values of non-specific laboratory tests, in the comparison between the studied groups, there was statistical relevance in the LTCD4+ count and viral load both at the time of the DTG exchange and one year after the study.