[의학신문·일간보사=김상일 기자]Since HIV-infected people have to take treatment for the rest of their lives, they cannot help but worry regarding the side effects caused by long-term use. In fact, according to a ViiV Healthcare survey of 2112 HIV-infected people worldwide, 68% of those infected were concerned regarding the long-term effects of HIV treatment.
In fact, even if widely used antiretroviral drugs are taken for a long time, latent toxicity or side effects are sometimes discovered 5 to 12 years later, so people with HIV who need lifelong treatment need more caution.
Reducing the number of HIV treatment drugs has the advantage of being free from the long-term drug burden as the number of drug components taken over a lifetime is greatly reduced. Assuming that the life expectancy of treatment is 39.1 years when the treatment is switched from a three-drug regimen that takes a treatment consisting of three components to a two-drug regimen, the number of drug components that an infected person takes during their lifetime is reduced to 28,543 doses compared to 42,815 doses. .
As a result of the survey, 73% of HIV-infected people also said that they would like to switch to a treatment with a lower number of ingredients if the virus was maintained.
Dovato is the world’s first two-drug treatment that pays attention to the unmet needs of infected people who have to continue treatment for life.
Dovato is a combination single tablet that combines two components, an integrase inhibitor (indolutegravir 50 mg and nucleoside reverse transcriptase inhibitor lamivudine 300 mg). It was approved domestically in March 2020.
Dovato is the result of a review of a number of strategies, such as reducing the number or dose of antiretroviral drugs, or discontinuing the use of PK boosters. Already, major global HIV treatment guidelines such as the U.S. Ministry of Health and Welfare and the European AIDS Clinical Society recommend Dovato as a first-line treatment.
Dobato’s main ingredient, dolutegravir, has proven its high resistance to growth and long-term tolerability through five large-scale phase 3 clinical trials.
These two components have similar pharmacokinetic (PK) profiles, and at the same time show complementary therapeutic effects with different mechanisms of action.
Meanwhile, the proportion of young people among newly infected people with HIV in Korea is gradually increasing. According to the 2021 HIV/AIDS Report Status Yearbook published by the Korea Centers for Disease Control and Prevention, out of 975 newly infected people in Korea, those in their 20s and 40s accounted for 81.3% of the total, which is regarding 2% higher than last year. As a result, the burden of long-term treatment for HIV-infected people is expected to increase.
HIV-infected people, like non-infected people, may become more vulnerable to cardiovascular disease, type 2 diabetes, liver and kidney disease as they age. According to the survey, among HIV-infected people, the proportion of those who took at least one drug other than HIV treatment daily reached a whopping 82%.
Dovato’s main ingredient, dolutegravir, has the lowest DDI (Drug-Drug Interactions) index, which analyzes drug interactions with other drugs, so there is relatively little concern regarding drug conflicts during concurrent treatment due to comorbidities. The point is also an advantage.
Previously, the three-drug regimen, which combined drugs with three components, was the standard for HIV treatment, but the birth of the world’s first two-drug therapy, Dovato, which reduced the number of drug components by one, presents a new paradigm for HIV treatment. .
