Is a Two-Drug Treatment Right for You?

Findings presented at the International AIDS Society 2019 Conference on HIV Science in Mexico City found that Dovato, a two-drug regimen of dolutegravir and lamivudine, suppresses HIV just as well as three-drug regimens — and with fewer side effects and zero drug resistance. The drug from ViiV Healthcare received Food and Drug Administration approval earlier this year for the treatment of people newly diagnosed with HIV.

The results of two landmark studies, GEMINI 1 and GEMINI 2, showed that after 96 weeks, Dovato continued to suppress HIV in the more than 1,400 study participants.

Dovato uses dolutegravir to inhibit HIV replication by preventing the viral DNA from integrating into the genetic material of T cells. This is key to HIV replication and also establishes chronic infection. Meanwhile, lamivudine interferes with viral RNA’s conversion into DNA, so the virus cannot multiply.

These results further add to the consensus that two-drug regimens can be as effective and safe as multi-drug regimens without raising drug resistance concerns. Previously, all HIV treatments included at least three medications so that if the virus developed resistance to one or two of the components it still couldn’t rebound. Now that newer drugs have proven less susceptible to drug resistance, researchers are demonstrating that these two-drug regimens can replace three-drug cocktails.

Benefits of reducing the number of drugs one takes go beyond improving adherence. It also raises hopes for fewer side effects and reduces risks of drug toxicity in long-term treatment. Plus, it opens the door for further improvements in HIV treatment.