Effect of doravirine on dolutegravir trough concentrations in people with HIV switched from darunavir/cobicistat.

Abstract

Dolutegravir and doravirine are individually safe and potent ART components, but their combined use has not been studied in clinical trials. Real-life experiences in small cohorts of highly treatment-experienced people with HIV have shown that combined treatment of dolutegravir with doravirine was well tolerated, achieving virological suppression in most cases.1,2 The potential pharmacokinetic drug–drug interaction (DDI) between the two drugs has been also investigated by Anderson et al.3 They found that doravirine co-administration increased dolutegravir exposure by about 25%–35%, a difference that was considered as not clinically relevant. However, it cannot be excluded that the co-administration of dolutegravir and doravirine in people with HIV instead of healthy volunteers may result in a different magnitude of DDI, as previously reported for other antiretroviral drugs.4–6 To address this issue, we considered people with HIV switched to doravirine from darunavir/cobicistat because we have previously shown that these antiretroviral drugs do not interact with dolutegravir.7,8