Switch studies in virologically suppressed patients

Switch to DRV/r + 3TC
DUAL Study: switch to DRV/r + 3TC
Original article : Pulido F, Clin Infect Dis 2017; 65:2112-8
Last update : 22/12/2017

Dr Anton Pozniak
Chelsea and Westminster Hospital
London, UK

  • Dual therapy with DRV/r plus 3TC was non-inferior regarding maintenance of viral suppression and equally well tolerated as DRV/r plus TDF/FTC (or ABC/3TC)
  • Persistent virological suppression was maintained after switching to dual therapy with DRV/r plus 3TC
  • These results reinforce the efficacy of dual therapy with a fully active boosted PI and 3TC for maintenance of virological suppression


* Randomisation was stratified by baseline nucleos (t)ides


  • Non inferiority of DRV/r + 3TC at W48: % HIV RNA < 50 c/mL by intention to treat-exposed, snapshot analysis (lower margin of the 2-sided 95% CI for the difference = - 12%, 80% power)

Baseline characteristics and disposition at W48

Efficacy results (HIV RNA < 50 c/mL by ITT-e, snapshot) at W48

Virologic outcome at W48

Virologic failure

  • HIV RNA > 50 c/mL in the W48 window
  • Discontinuation before W48 due to lack of efficacy

Virologic failure and viral blips

HIV- 1 RNA > 400 c/mL and emergence of resistance

Adverse events, %

Percent mean change in fasting lipids according to NRTI backbone at screen

Mean change in eGFR (Cockroft-Gault), mL/min

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