Efficacy of Dolutegravir Plus Lamivudine in People With TB/HIV Co-Infection Using a Rifampicin or Rifabutin-Based Regimen: A Retrospective Observational Case Series.

Publisher: John Wiley and Sons Ltd Country of Publication: England NLM ID: 101635460 Publication Model: Print Cited Medium: Internet ISSN: 2050-4527 (Electronic) Linking ISSN: 20504527 NLM ISO Abbreviation: Immun Inflamm Dis Subsets: MEDLINE

Original Publication: [Oxford] : John Wiley and Sons Ltd, [2013]-

Pyridones*/therapeutic use ; HIV Infections*/drug therapy ; Lamivudine*/therapeutic use ; Rifabutin*/therapeutic use ; Coinfection*/drug therapy ; Heterocyclic Compounds, 3-Ring*/therapeutic use ; Heterocyclic Compounds, 3-Ring*/administration & dosage ; Rifampin*/therapeutic use ; Tuberculosis*/drug therapy ; Piperazines*/therapeutic use ; Anti-HIV Agents*/therapeutic use; Oxazines/therapeutic use ; Viral Load/drug effects ; Humans ; Male ; Retrospective Studies ; Female ; Adult ; Middle Aged ; Drug Therapy, Combination ; Treatment Outcome ; HIV-1 ; CD4 Lymphocyte Count

Introduction: Co-infection with tuberculosis (TB) is the leading cause of death in individuals infected with human immunodeficiency virus (HIV)-1. Dolutegravir and lamivudine (DTG + 3TC) has recently been recommended as the preferred first-line regimen for the treatment of new and treatment-experienced HIV-infected patients. The primary objective of this study was to determine the efficacy and safety of DTG (50 mg) + 3TC (300) mg in HIV-positive antiretroviral therapy (ART)-naïve patients with TB who received a rifampicin- or rifabutin-based treatment regimen and characterize viral suppression rates at week 48.
Methods: A single-center retrospective observational case series, spanning January 1, 2021 to March 1, 2023, was conducted in Guiyang Public Health Treatment Center. Of 46 TB/HIV co-infected patients received DTG + 3TC or DTG/3TC, a total of 42 patients were finally enrolled in the study. The outcomes of interest were successful TB treatment, viral load (VL) suppression, and immunological and biochemical indexes.
Results: All people with HIV infection (PWH) underwent at least 48 weeks of follow-up; all TB treatments were successful. A total of seven PWH (100%) achieved viral suppression (VL < 50 copies/mL) from a baseline VL greater than 500,000 copies/mL. Among the PWH who started DTG + 3TC after initiating the rifabutin-based anti-TB regimen, 31 (73.8%) achieved viral suppression by week 24. CD4 + T-cell counts were greatly improved after antiretroviral treatment. The CD4 + /CD8+ ratio increased by 0.38 (p < 0.001). Total cholesterol, and high-density lipoprotein cholesterol (p < 0.05). There were no significant changes in body mass index, low-density lipoprotein cholesterol, and triglyceride levels from baseline to week 48 (p > 0.05). No serious adverse events were observed.
Conclusion: This case series preliminarily validated the efficacy of DTG + 3TC when combined with rifabutin-based anti-TB regimens in patients with TB and HIV.
(© 2026 The Author(s). Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.)

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the Science and Technology Foundation of Guizhou Province; [2025ZD01905202] National Science and Technology Major Project for Prevention and Control of Emerging and Major Infectious Diseases

Keywords: HIV‐1 infection; dolutegravir; efficacy; safety; tuberculosis

0 (Pyridones)
2T8Q726O95 (Lamivudine)
1W306TDA6S (Rifabutin)
0 (Heterocyclic Compounds, 3-Ring)
VJT6J7R4TR (Rifampin)
0 (Piperazines)
0 (Oxazines)
0 (Anti-HIV Agents)

Date Created: 20260322 Date Completed: 20260322 Latest Revision: 20260423

20260423

PMC13098156

10.1002/iid3.70381

41866305