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Dolutegravir + rilpivirine (Juluca°) dual therapy in HIV infection

Prescrire's rating

NOTHING NEW In patients who have an undetectable viral load for at least one year and no history of HIV resistance after taking triple antiretroviral therapy, two comparative trials in a total of 1024 patients showed that switching to dolutegravir + rilpivirine dual therapy is no less effective in the short term than continuing triple therapy. However, dolutegravir + rilpivirine has not been compared with triple therapy in patients who did not tolerate a previous three-agent regimen, and the trials did not show that decreasing the number of antiretroviral drugs from 3 to 2 offered any particular clinical advantage. Combining rilpivirine with a single antiretroviral rather than two may increase the risk of resistance, especially in case of poor adherence.