Treatment-Resistant HIV May Have Met Its Match

A major international clinical trial led by the Kirby Institute at the University of New South Wales, Sydney presented results on two simplified second-line HIV treatment options that were shown to be at least as effective as current approaches.

“Second-line” refers to treatment options available to those with HIV whose initial treatment is ineffective. According to a press release from the Kirby Institute, this impacts nearly 10 percent of the global HIV population.

The new discovery could provide treatment options for over 3 million HIV-positive people globally whose initial treatment fails. This could also prove a critical improvement in increasing treatment accessibility in low- and middle-income nations.

The new treatment options from the D²EFT study were designed to compare a standard approach for second-line HIV treatment against two alternative regimens. They were found to be at least as good as the standard of care in achieving viral suppression, but also carry potential benefits in cost, tolerability, and simplification.

“The finding of non-inferiority has significant implications for the management of HIV globally,” Professor Matthew Law of the Kirby Institute said during the results presentation at the Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle. “Adopting either of these simplified treatments could mean administering fewer pills, avoids the need for specialized resistance tests, and reduces the cost of medication.”

The study enrolled 831 patients from 14 countries, where the patients were randomized to one of the three arms.

“The findings further reinforce the current WHO recommendation of using dolutegravir as the preferred antiretroviral option, while also providing new insights into the simplification of second-line HIV treatment in low- and middle-income countries,” said Meg Doherty, Director of WHO’s Global HIV, Hepatitis and Sexually Transmitted Infections Programs in Geneva.