Two Cases of Viral Re-suppression After M184V + R263K Selection on Dolutegravir/Lamivudine Without Treatment Modification

Clin Infect Dis. 2024 Jul 19;79(1):198-201. doi: 10.1093/cid/ciae006.

Abstract

Dolutegravir/lamivudine (DTG/3TC) has a high genetic barrier against the development of human immunodeficiency virus drug resistance. We report 2 cases of R263K + M184V mutations during DTG/3TC failure followed by viral suppression after adherence intervention without treatment change that we attribute to residual drug activity, reduced viral fitness, and robust immune competence.

Keywords: HIV; adherence; dolutegravir; lamivudine; resistance.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-HIV Agents* / therapeutic use
  • Drug Resistance, Viral* / genetics
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / virology
  • HIV-1 / drug effects
  • HIV-1 / genetics
  • Heterocyclic Compounds, 3-Ring* / therapeutic use
  • Humans
  • Lamivudine* / therapeutic use
  • Male
  • Middle Aged
  • Mutation
  • Oxazines* / therapeutic use
  • Piperazines* / therapeutic use
  • Pyridones* / therapeutic use
  • Viral Load / drug effects

Substances

  • Heterocyclic Compounds, 3-Ring
  • dolutegravir
  • Pyridones
  • Lamivudine
  • Piperazines
  • Oxazines
  • Anti-HIV Agents