TOPLINE

Adding doravirine to existing antiretroviral therapy (ART) regimens helped achieve virologic control in people living with HIV with a recent viral rebound or prolonged low-level viremia.

METHODOLOGY

• Researchers conducted a multicenter observational study, involving 123 people living with HIV with a documented genotypic susceptibility score (GSS) to assess whether adding doravirine to existing ART regimens could help achieve virologic control.
• Patients were divided into two groups based on virologic status:
  • Group A (n = 84; mean age, 42.7 years): Patients with a recent viral rebound (two successive HIV-1 viral loads exceeding 50 copies/mL).
  • Group B (n = 39; mean age, 45.2 years): Patients with prolonged low-level viremia (viral load between 50 and 200 copies/mL for > 1 year).
• Doravirine was added to existing ART regimens without modifying other antiretroviral components, and virologic response at 6 months was evaluated as the percentage of people living with HIV with a viral load less than 50 copies/mL.
• The GSS, reflecting the number of fully active drugs in the background ART regimen combined with doravirine, was evaluated for its association with virologic response.

TAKEAWAY

• In group A, the virologic success rate at 6 months was 100% for patients with GSS 2-3, 81% for those with GSS 1, and 0% for those with GSS 0; the overall virologic success rate in this group was 88%.
• In group B, the virologic success rate was lower, 39% for patients with GSS 2-3, 22% for those with GSS 1, and 0% for those with GSS 0; the overall virologic success rate in this group was 33%.
• Doravirine resistance mutations emerged in 3.6% of group A patients and 15.4% of group B patients, while 10.5% of group B patients demonstrated actual resistance.

IN PRACTICE

“This study suggests that adding doravirine to other active drugs (high GSS) can be an effective strategy for managing recent virological failures. However, this strategy is less effective with prolonged low-level viremia, but it may be considered on a case-by-case basis,” the authors wrote.

SOURCE

The study was led by Vincent Calvez of Sorbonne Université, INSERM, Institut Pierre Louis D’Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Laboratoire de Virologie in Paris, France. It was published online on June 22, 2026, in Journal of Antimicrobial Chemotherapy.

LIMITATIONS

The study was limited by its small sample size, the groups were not evenly balanced, and baseline viral loads differed between groups. Additionally, this was an observational study with no comparison group and a short follow-up period.

DISCLOSURES

The study received support from Agence Nationale de Recherches sur le SIDA et les Hépatites virales — Maladies Infectieuses Emergentes and Merck Sharp & Dohme. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.