{"id":22521,"date":"2023-11-15T14:51:06","date_gmt":"2023-11-15T14:51:06","guid":{"rendered":"https:\/\/i-base.info\/qa\/?p=22521"},"modified":"2023-11-15T14:51:06","modified_gmt":"2023-11-15T14:51:06","slug":"should-i-switch-to-dovato-2","status":"publish","type":"post","link":"https:\/\/i-base.info\/qa\/22521","title":{"rendered":"Should I switch to Dovato?"},"content":{"rendered":"

Hi, how are you doing?<\/p>\n

\n<\/p>

Is Truvada and Raltegravir the first combination of ART you have used? and what is your current viral load and CD4 count?<\/p>\n

\n<\/p>

In the last 5 years have you had any problems with your current regimen? Any side effects\/long term health concerns? Is the sole reason of switching to move to a single tablet instead of 2?<\/p>\n

\n<\/p>

Dovato:\u00a0https:\/\/i-base.info\/guides\/14379<\/a><\/p>\n

\n<\/p>

It is a recommended switch to a 2 drug regimen when virologically suppressed. It is not a suitable switch in people who have any of the following:<\/p>\n

\n
    \n
  1. History of failure on an INSTI regimen or resistance to lamivudine\/INSTI ART.<\/li>\n
  2. Hepatitis B co-infection.<\/li>\n
  3. At risk of Hep B infection with no known immunity.<\/li>\n<\/ol>\n

    The switch from a 3-drug regimen to a 2-drug regimen is supported by the TANGO study:\u00a0https:\/\/i-base.info\/htb\/36450<\/a><\/p>\n\n

    This study showed that after 48 weeks a drug regimen was non-inferior to the 3-drug. Small differences were noted in kidney and bone markers between 3-drug and 2-drug but this is unlikely to have clinical significance. Both groups had a similar amount of weight gain leading to similar cardiovascular health outcomes.<\/p>\n\n

    There was a meta-analaysis on dolutegravir and cardiovascular health. This is a type of study that looks at a number of studies with the same sort of data and compares them to check if they are right. This study showed that dolutegravir does not increase the risk of cardiovascular health problems in comparison to other anti-retrovirals.<\/p>\n\n

    The study can be found here:\u00a0https:\/\/pubmed.ncbi.nlm.nih.gov\/29278532\/<\/a><\/p>\n\n

    For this reason, concerns about switching to a dolutegravir based regimen on the risk of cardiovascular problems should not be considered. How is your current cardiovascular health e.g., blood pressures, cholesterol\/lipids and weight?<\/p>\n\n

    Where in the UK are you based? If you are seeking easier treatment options have you considered using the injectable ART? This is newly rolled out and is not avialable at every clinic in the UK but can be wroth enquiring about. It requires only an injection every other month with no daily treatment.<\/p>\n\n

    Injectable ART:\u00a0https:\/\/i-base.info\/qa\/20696<\/a><\/p>\n\n

    Josh.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

    I\u2019ve been on Truvada and Raltegravir for 4 or 5 years and I\u2019ve decided to switch to Dovato once daily. Two active drugs instead of 3 appeals to me and taking only 1 pill is much easier. However I\u2019m now having second thoughts due to the emerging evidence of side effects associated with Douletegravir especially
    \nthose associated with the heart. Do you think this is a sensible switch or not? I have no real reason to switch other than the fact I\u2019d like to explore the possibility of better long term health with less side effects through reducing the number of drugs in the combo. Any advice would be much appreciated thanks.<\/p>\n","protected":false},"author":18,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7,10,53],"tags":[],"class_list":["post-22521","post","type-post","status-publish","format-standard","hentry","category-all-topics","category-changing-treatment","category-research"],"_links":{"self":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/22521","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/users\/18"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/comments?post=22521"}],"version-history":[{"count":1,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/22521\/revisions"}],"predecessor-version":[{"id":22522,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/22521\/revisions\/22522"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/media?parent=22521"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/categories?post=22521"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/tags?post=22521"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}