Virological Suppression in People Living with HIV-1 (PLWH) Receiving Dolutegravir/Lamivudine Was High and Similar across Age Groups Despite Older Plwh Having Increased Rates of Comorbidities and Polypharmacy (TANDEM SUBGROUP)

Speaker(s)

Brogan A1, Slim J2, Verdier G1, Harper G3, Mycock K3, Wallis H3, Donovan C1
1ViiV Healthcare, Durham, NC, USA, 2Saint Michael's Medical Center, Newark, NJ, USA, 3Adelphi Real World, Bollington, UK

Presentation Documents

OBJECTIVES:

Aging with HIV has unique challenges, including comorbidities and drug-drug interactions. TANDEM was a retrospective medical chart review conducted across 24 US sites. This subgroup analysis examines stable-switch PLWH receiving dolutegravir/lamivudine by age.

METHODS:

Eligible PLWH were adults initiating dolutegravir/lamivudine prior to Sept/30/2020 with ≥6 months clinical follow-up. Stable-switch PLWH were defined as having HIV-1 RNA <50 copies/mL and on a stable antiretroviral regimen for ≥3 months upon dolutegravir/lamivudine initiation. Clinical characteristics, treatment history, and outcomes were analyzed for 3 age groups among dolutegravir/lamivudine stable-switch PLWH. Analyses were descriptive.

RESULTS:

The number of dolutegravir/lamivudine stable-switch PLWH in each age group was 86 (<50 years), 106 (≥50 years), and 20 (≥65 years). A greater proportion of PLWH in the older age groups were female sex at birth (14.0% <50 years; 20.8% ≥50 years; 30.0% ≥65 years). More PLWH in older age groups had reported comorbidity (12.8% <50 years; 34.9% ≥50 years; 45.0% ≥65 years) and polypharmacy (5.8% <50 years; 17.9% ≥50 years; 30.0% ≥65 years). Avoidance of long-term toxicities was the biggest driver for initiating dolutegravir/lamivudine in the older age groups (32.1% ≥50 years; 30.0% ≥65 years) while simplification/streamlining of treatment was the most common (27.9%) primary reason for PLWH to switch to dolutegravir/lamivudine in the <50 years group. For PLWH <50 years, 95.3% remained virologically suppressed for the study period. Similarly, 96.2% of PLWH ≥50 years and 95.0% of PLWH ≥65 years remained virologically suppressed for the study period. Three patients with NRTI resistance at baseline remained suppressed.

CONCLUSIONS:

Virological suppression rates were high and similar by age group among dolutegravir/lamivudine stable-switch PLWH despite higher rates of comorbidities and polypharmacy in the older age groups. This real-world analysis is consistent with clinical study data supporting dolutegravir/lamivudine as an effective treatment strategy in older PLWH.

Code

SA49

Topic

Clinical Outcomes, Study Approaches

Topic Subcategory

Clinical Outcomes Assessment, Electronic Medical & Health Records

Disease

Geriatrics