Virological Failure in HIV to Triple Therapy With Dolutegravir-Based Firstline Treatment: Rare but Possible

M J Pena; N Chueca; A D'Avolio; J M Zarzalejos; F Garcia

doi:10.1093/ofid/ofy332

Virological Failure in HIV to Triple Therapy With Dolutegravir-Based Firstline Treatment: Rare but Possible

Open Forum Infect Dis. 2018 Dec 10;6(1):ofy332. doi: 10.1093/ofid/ofy332. eCollection 2019 Jan.

Authors

M J Pena¹, N Chueca², A D'Avolio³, J M Zarzalejos⁴, F Garcia²

Affiliations

¹ Servicio de Microbiología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de GC, Gran Canaria, Spain.
² Unidad de Gestión Clínica de Microbología, Hospital Universitario San Cecilio, Insitituto de Investigación IBS, Granada, Spain.
³ Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin - ASL "Città di Torino," Torino, Italy.
⁴ Servicio de Medicina Interna, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Gran Canaria, Spain.

Abstract

We describe a case of virological failure during initial treatment with tenofovir disoproxil fumarate/emtricitabine/dolutegravir twice daily, with concomitant rifampin treatment of staphylococcal infection, selection of R263K + E157Q, and low plasma dolutegravir levels. Using rifampin together with dolutegravir may require closer follow-up, and, if possible, plasma dolutegravir levels should be monitored.

Keywords: dolutegravir; failure; firstline.