Real‐world effectiveness and safety of switching to dolutegravir/lamivudine among people living with HIV‐1 aged over 50 years who are virologically suppressed

Objectives People living with HIV face several challenges as they age, including the potential for polypharmacy and increased susceptibility to drug‐related adverse effects. Thus, effective and well‐tolerated regimens with minimal or no drug interactions would be useful in this population. We present real‐world effectiveness and safety data for individuals aged >50 years who achieved virological suppression (HIV‐1 RNA <50 copies/mL) and switched to dolutegravir/lamivudine (DTG/3TC). Methods This retrospective, observational, single‐centre study conducted in Portugal included individuals aged >50 years who switched to DTG/3TC while virologically suppressed and had ≥12 months of follow‐up. Proportions of individuals maintaining virological suppression were described at 12 months; CD4+ cell counts were described at baseline and 12 months. Descriptive subgroup analyses were performed based on age, sex assigned at birth, and availability of historical genotypic resistance results. Results Overall, 538 individuals aged >50 years were included (74% male; mean age, 62 years; mean time on previous therapy, 160 months). High proportions (intention‐to‐treat population, 97%; on‐treatment population, 98%) of individuals who switched to DTG/3TC maintained virological suppression through 12 months of follow‐up. CD4+ cell counts remained stable (mean baseline: 727 cells/mm 3 [range 94–2371]; mean month 12: 742 cells/mm 3 [range 99–2659]). No individuals experienced virological failure. Nine (2%) individuals discontinued DTG/3TC for non–treatment‐related reasons. Proportions with virological suppression at month 12 were similar between on‐treatment subgroups by age, sex assigned at birth, and historical genotypic resistance results availability. Conclusions DTG/3TC demonstrated robust effectiveness and a good safety profile in individuals aged >50 years with virological suppression in Portugal.