Question
Should I switch to Dovato?
14 September 2023. Related: All topics, Changing treatment.
I am currently taking Biktarvy and have no problems with it and remain undetectable at each 6 monthly check up. However I am aware there is a 2 drug combination called Dovoto. Is it worth changing to this?
Been told Dovato gives nightmares, so what is the point on a new initiative drug if it has this side effect!
Answer
Hi, how are you doing?
It is great that you are doing well on Biktarvy and have remained undetectable.
Doavato is a 2 drug tablet that contains dolutegravir and lamivudine. Dovato does not cause nightmares, rather it can cause problems sleeping. This is because it contains dolutegravir. People avoid this side effect by taking it earlier in the day.
Doavato is a 2 drug tablet but it is often combined with another tablet to make it a 3-drug regimen. Usually this drug is tenofovir. Together it makes TLD.
Biktarvy is a newer combination and is usually recommended first line ahead of TLD when the option is available. For this reason as you are doing well on Biktarvy it would not be recommended to switch to a Daovato based regimen.
Josh.
Hi Freshie, thanks for sharing your experience and your results show how effective modern HIV meds can be. Their impact on HIV doesn’t mean that they have a bad effect on your body though. Your body, including your liver, is very good at filtering meds – and it does this for everything else you body comes into contact with. You HIV meds are not wearing out your liver – actually your liver is very happy doing what it is meant to do. The meds in Biktarvy also use much lower milligram doses than many other combinations. The meds in Biktarvy are not linked with kidney problems either but I don’t know the details of your reduced kidney function.
Several studies have shown that people generally stay undetectable after switching from three-drug ART like Biktarvy to two-drug Dovato. One caution might be that your viral load was very high when your started ART, but this was also because you were in early infection.
If you do decide to switch, perhaps monitor your viral load more closely over the next few months. Perhaps also see whether this makes any dofference to the markers of you kifney function. You can always return to Biktarvy later if you need to or want to.
Bith options will help you lead a long and healthy life :)
Hi,y seroconversion took place , I became HIV+, five years ago. It was great that Biktarvy took me from over 5 million viral load to undetectable in about 30 days. But over time I’ve become concerned that such a powerful medicine is having to be dealt with every day by my liver, kidney, etc. My specialist doctor has, on looking at blood test results and seeing reduced kidney function, recommended switching to Dovato, as it easier for the body to metabolise. I’m very happy to do that. I had previously approached Gilead ( the Biktarvy company) to see whether they were considering a maintenance dose, something less powerful. No was the answer. I’d prefer to live longer, so of the two, Dovato it has to be