• Maria Mazzitelli, Melania Degli Antoni, Francesco Castelli, Diego Ripamonti, Gianluca Zuglian, Giuseppe Lapadula, Massimiliano Fabbiani, Alice Ferraresi, Cristina Putaggio, Anna Maria Cattelan, and Eugenia Quiros-Roldan.
• Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy.
• Medicine (Baltimore). 2022 Jul 29; 101 (30): e29855e29855.

AbstractUse of doravirine (DOR), a new nonnucleoside reverse-transcriptase inhibitors recently approved for HIV treatment, is still unclear in clinical practice and real-life data are scarce. We retrospectively investigated the rationale for switching people with HIV to DOR-containing/-based regimens in a real-life cohort. Among 132 patients (68.9% males, median age 56 years), the main reasons to start DOR were prevention of toxicities (39.4%) and dyslipidemia (18.2%). DOR was combined with integrase inhibitors in 40.9% cases, and in 25.7% of patients, DOR was prescribed without availability of a genotypic resistance test. Twenty-four weeks after the switch to DOR-containing/-based regimens, no significant changes in CD4+ T-cell count, CD4/CD8 ratio, detectable HIV-RNA, serum creatinine levels, and body weight were detected. By contrast, a significant reduction in lipids (both cholesterol and triglycerides) was observed in 52 patients for whom a follow-up assessment was available (P = .008 and .01, respectively). Our data confirmed that switching to DOR-containing/-based regimens may have a favorable impact on lipid profile and a neutral impact on weight gain. However, more data are needed to support its use in patients who do not have a genotypic test available or have an extensive nonnucleoside reverse-transcriptase inhibitors-associated resistance, as well as its use in a dual regimen, especially in combination with second-generation integrase inhibitors.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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