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M.E.Λ. Νοσοκομείου Ηρακλείου Κρήτης

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Lancet

Πρόσφατες δημοσιεύσεις στο περιοδικό The Lancet HIV

Lenacapavir plus two bNAbs: feasible, with some caveats

Antiretroviral therapy (ART) has reached very high levels of efficacy, tolerability, and convenience.1 Combining oral drugs in a single pill once daily is the current gold standard for ART. As HIV cure remains elusive, the simplification of therapy is desired for many people with HIV.2 We know that a combination of at least two drugs is needed: monotherapy, even with potent and high-genetic barrier drugs such as boosted protease inhibitors or dolutegravir, has led to an increased risk of virological failure, with potential for class resistance mutations, particularly in the case of dolutegravir.

The role of HIV biology in defining virological failure

In this issue of The Lancet HIV, Graeme Moyle and colleagues1 report 48-week results from the proof-of-concept WISARD trial. In the trial, 140 people with HIV who were virologically suppressed on antiretroviral therapy (ART) and had Lys103Asn mutations in a past clinical genotype were randomly assigned to either switch to dolutegravir plus rilpivirine or to continue their current treatment. Confirmed virological failure, defined as two consecutive measurements of plasma HIV RNA concentrations of greater than 50 copies per mL at least 2 weeks apart, was reported in three (3%) of 95 participants in the dolutegravir plus rilpivirine group versus one (2%) of 45 participants in the control group.

HIV self-testing, PrEP, and drug resistance: some insights

Global efforts to end the AIDS pandemic by 2030 depend in part on expanding the use of effective prevention tools and also ensuring these tools remain effective. These tools include expanding tenofovir disoproxil fumarate-based pre-exposure prophylaxis (PrEP) services, including testing, as part of comprehensive prevention for people at substantial risk of HIV infection.1 Community HIV self-testing is both feasible and effective in HIV diagnosis making it a valuable supplementary option for initiating and promoting increased uptake of PrEP services.

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