Dolutegravir/Lamivudine as a First-Line Regimen in a Test-and-Treat Setting for Newly Diagnosed People Living With HIV

Charlotte-Paige Rolle; Mezgebe Berhe; Tulika Singh; Roberto Ortiz; Anson Wurapa; Moti Ramgopal; Peter A. Leone; Jessica E. Matthews; Marybeth Dalessandro; Mark R. Underwood; Konstantinos Angelis; Brian R. Wynne; Deanna Merrill; Christopher Nguyen; Jean van Wyk; Andrew R. Zolopa


AIDS. 2021;35(12):1957-1965. 

In This Article


These data offer further evidence that DTG/3TC is an effective, well tolerated, two-drug single-tablet option that offers newly diagnosed PWH the ability to start effective therapy using fewer antiretroviral agents. Based on prior studies, advantages of initiating DTG/3TC include reduced short-term and long-term toxicity secondary to reduced cumulative ART exposure, fewer drug–drug interactions, and possible metabolic advantages. In addition, DTG/3TC may be a cost-effective option for PWH. Considering the high lifetime costs associated with ART,[22] DTG/3TC has been associated with cost savings when compared with three-drug or four-drug regimens.[23] Despite questions about its utility, primary results from STAT support the feasibility of rapid DTG/3TC initiation and provide preliminary evidence that ART modifications can be performed safely via routine clinical care in the presence of baseline resistance or HBV co-infection to achieve virologic efficacy, thus providing the potential advantages of DTG/3TC as soon as the day of diagnosis.