AUTHOR=Wang Qing , Xie Xiaoxin , Fu Yanhua , Yang Xiaoyan , Gan Lin , Ma Shujing , Jiao Pengzhu , Wu Muli , Li Jun , Long Hai 

TITLE=Efficacy and safety of dolutegravir plus lamivudine for patients with late presentation of HIV-1 infection: a retrospective real-world cohort study in Southwest China

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1630960

DOI=10.3389/fmed.2025.1630960

ISSN=2296-858X

ABSTRACT=BackgroundEvidence regarding the use of dolutegravir plus lamivudine (DTG + 3TC) among patients with HIV infection who present late remains limited. This study aimed to evaluate the effectiveness and safety of DTG + 3TC therapy in patients with late presentation in Southwest China.MethodsThis single-center, retrospective cohort study included patients with late presentation who initiated DTG + 3TC anti-retroviral therapy (ART) between January 2020 and July 2023 (N = 176). Changes in immunologic and metabolic parameters as well as liver and kidney function, were assessed. The primary endpoint was the proportion of participants with HIV-1 RNA < 50 copies/mL at week 48. Late presentation was defined as CD4 < 350 cells/μL or the presence of AIDS-defining conditions.ResultsAt weeks 24 and 48, 83.0% (146/176) and 90.9% (160/176) of the patients achieved HIV-1 RNA levels <50 copies/mL, respectively. At week 48, the median CD4 count increased by 139.5 cells/μL (120.5–158.5), and the CD4/CD8 ratio increased by 0.2 (0.1–0.3) (p < 0.001). No patient discontinued treatment owing to adverse events during the observation period.ConclusionDTG + 3TC demonstrated high virologic efficacy and good tolerability in patients with late presentation. However, the regimen may be associated with an increase in lipid levels and weight, highlighting the need for regular monitoring.