P-576. Real-world Experience with the Two-Drug Regimen Dolutegravir/Lamivudine for the Treatment of HIV-1 among Vulnerable People Living with HIV in Canada: Preliminary Results from a Chart Review Study
Notice bibliographique
Résumé
Abstract Background Compared to the general population of people living with HIV, vulnerable people, such as those who use drugs, are disproportionately affected by HIV, and are predisposed to lower adherence to antiretroviral therapies (ARTs), which may result in poorer virologic suppression, worse health outcomes, and higher HIV transmission rates. Some may benefit from simpler single-tablet regimens that are effective, well tolerated, and limit exposure to unnecessary medications. We evaluated clinical outcomes in vulnerable people living with HIV who switched to the single-tablet, 2-drug regimen dolutegravir/lamivudine (DTG/3TC). Methods This ongoing chart review study included people living with HIV (≥ 18 years) in Canada who switched to DTG/3TC between 09/09/2019 and 31/05/2023, and had ≥ 1 of the following vulnerability criteria: recent drug use, opioid agonist use, recent or well-documented history of unstable housing or receiving social assistance, Indigenous identity, or ≥ 65 years of age with diminished autonomy (‘vulnerable senior’). Descriptive summary statistics were generated for demographic and clinical characteristics at baseline (≤ 12 months pre-switch), and viral load and CD4+ cell counts at 6 (± 2) and 12 (± 2) months post-switch. Interim results are reported for the ongoing study. Results Across 5 sites, 20 eligible people were included (mean age: 49.9 ± 13.0 years; male: 80%; drug use: 80%; vulnerable senior: 20%). Simplification of ART was the predominant reason for switch to DTG/3TC (n=11, 55%). At the time of analysis, 80% (n=16) had at least 6 months of follow-up, and one discontinued DTG/3TC due to intolerance. At 6 months, of those with test results, 8/8 were virally suppressed (< 50 c/mL), and median (IQR) CD4+ cell count was 815 (122.5) cells/mm3. At 12 months, 11/12 were virally suppressed (< 50 c/mL), and median CD4+ cell count was 920 (180) cells/mm3 (n=10). Conclusion Preliminary results suggest promising effectiveness outcomes among vulnerable people living with HIV who switch to DTG/3TC. These results support the continued expansion of this study to include more people. Disclosures Emmanuelle Huchet, MD, AbbVie: Honoraria|Gilead Sciences: Advisor/Consultant|Gilead Sciences: Honoraria|Indivior: Advisor/Consultant|ViiV Healthcare: Advisor/Consultant Joann K. Ban, PharmD, MSc, GSK: employee Adenike R. Adelakun, BPharm, MSc, GSK: employee Katherine Osenenko, MCPM, Broadstreet HEOR: employee|ViiV Healthcare: Funding for the conduct of this work Isabelle Hardy, PhD, ViiV Healthcare: employee Elaine Stewart, HBSc, ViiV Healthcare: employee Michael McKimm, BSc, ViiV Healthcare: employee Jean-Francois Fortin, MD, ViiV Healthcare: employee Madeleine Crabtree, MPH, Broadstreet HEOR: employee|ViiV Healthcare: Funding for the conduct of this work Karissa Johnston, MSc, PhD, Broadstreet HEOR: employee|ViiV Healthcare: Funding for the conduct of this work Brian Conway, MD, AbbVie: Advisor/Consultant|AbbVie: Grant/Research Support|AbbVie: Honoraria|AstraZeneca: Advisor/Consultant|AstraZeneca: Grant/Research Support|AstraZeneca: Honoraria|Gilead Sciences: Advisor/Consultant|Gilead Sciences: Grant/Research Support|Gilead Sciences: Honoraria|GSK: Advisor/Consultant|GSK: Grant/Research Support|GSK: Honoraria|Indivior Canada: Advisor/Consultant|Indivior Canada: Grant/Research Support|Indivior Canada: Honoraria|Merck: Advisor/Consultant|Merck: Grant/Research Support|Merck: Honoraria|Moderna: Advisor/Consultant|Moderna: Grant/Research Support|Moderna: Honoraria|Sanofi Pasteur: Advisor/Consultant|Sanofi Pasteur: Grant/Research Support|Sanofi Pasteur: Honoraria|Seqirus: Advisor/Consultant|Seqirus: Grant/Research Support|Seqirus: Honoraria|ViiV Healthcare: Advisor/Consultant|ViiV Healthcare: Grant/Research Support|ViiV Healthcare: Honoraria V. Paul DiMondi, PharmD, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».