The purpose of this project was to conduct a literature review to assess the evidence to support dolutegravir (DTG) usage on people co-infected with TB or Hepatitis, in state of malnourishment and pregnant woman.
The findings in the systematic reviews consistently point to greater efficacy and reduced rates of discontinuation due to side effects for DTG in comparison with normal dose EFV when used in treatment of adults. DTG also seems safer though the evidence for the latter is less strong, which may be caused by the low rate of adverse events in combination with high drop‐out rates in some studies. Improved efficacy, safety and tolerability was found also in the subset of studies that compared TLD with TLE regimens. The clinical importance of these findings may however be limited. Current evidence on efficacy, tolerability and safety of DTG in pregnant or breast feeding women, and in patients co‐infected with hepatitis or TB is still lacking. While evidence in adolescents is very limited and insufficient to make firm recommendations. This means that at present DTG based regimens should not be used for these groups and first‐line therapy should continue to be based on drugs for which adequate safety data are available. Further evidence on use of DTG in subgroups is expected to be available around 2020. Differentiating first line treatment regimens according to patient subgroups is feasible but not ideal and could plea against a switch.
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