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Antiretroviral Medications and Initial TherapyQuestion 6/10

A 26-year-old man was diagnosed with HIV 7 weeks prior. His initial laboratory studies showed an HIV RNA level of 108,656 copies/mL, a CD4 count 342 cells/mm3, positive hepatitis B surface antibody (HBsAb), and negative hepatitis B surface antigen (HBsAg). He missed his initial follow-up appointment to start antiretroviral therapy. Results from an HIV drug resistance genotype test are now available and show no resistance mutations. He has never taken HIV preexposure prophylaxis (PrEP).

Is this man a candidate to receive 2-drug therapy with dolutegravir-lamivudine?

Figure 1. GEMINI 1 and 2: Week 48 Results
Source: Cahn P, Madero JS, Arribas JR, et al. Dolutegravir plus lamivudine versus dolutegravir plus tenofovir disoproxil fumarate and emtricitabine in antiretroviral-naive adults with HIV-1 infection (GEMINI-1 and GEMINI-2): week 48 results from two multicentre, double-blind, randomised, non-inferiority, phase 3 trials. Lancet. 2019;393:143-55.
Figure 2. GEMINI 1 and 2: Week 96 Results
Source: Cahn P, Madero JS, Arribas JR, et al. Durable Efficacy of Dolutegravir Plus Lamivudine in Antiretroviral Treatment-Naive Adults With HIV-1 Infection: 96-Week Results From the GEMINI-1 and GEMINI-2 Randomized Clinical Trials. J Acquir Immune Defic Syndr. 2020;83:310-18.
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Question Last Updated
January 28th, 2025

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