Dolutegravir Antiretroviral Strategy to Promote Improvement and Reduce Drug Exposure (ASPIRE) Study
HIV-1 infected subjects with CD4 nadir \> 200 cells/mm3, no history of virologic failure and plasma HIV RNA \<50 copies/mL for at least 48 weeks while on any United States Department of Health and Human Services (DHHS) recommended or alternative three-drug antiretroviral regimen will be randomized to dolutegravir (DTG) plus lamivudine (Arm 1) or continuation of their current regimen (Arm 2) for 48 weeks. The primary endpoint is virologic failure defined as confirmed plasma HIV-1 RNA \> 50 copies/mL before or at Week 24
• HIV-1 Infection
• HIV-1 RNA \<50 copies/mL on all measurements within 48 weeks prior to study entry while on any DHHS recommended or alternative three-drug antiretroviral regimen. (A history of switching for simplification and/or tolerability is allowed. At least two measurements within the previous 48 weeks are required prior to study screening.)
• No history of virologic failure, defined as consecutive HIV RNA \> 50 copies/mL after 12 months of initiating ART. An isolated (non-consecutive) HIV RNA \> 50 copies/mL (but less than 400 copies/mL) is permitted after 12 months of initiating ART but not in the 48-week window prior to study entry.
• Screening plasma HIV RNA \< 20 copies/mL using the COBAS AmpliPrep/COBAS TaqMan HIV-1 Test V2.0, obtained within 45 days prior to study entry
• Nadir CD4 count \>200 cells/mm
• Pretreatment genotype documenting no mutations in the protease or reverse transcriptase genes
• No known resistance to integrase inhibitors
• Laboratory values obtained within 45 days prior to study entry:
⁃ ANC \>750 Hemoglobin \>10 g/dL Platelets \>50,000 Calculated creatinine clearance (CrCl) \>50 mL/min
• Negative serum or urine pregnancy test
• Men and women age greater or equal to 18 years.
• Ability to continue current regimen (i.e, have uninterrupted access)
• No evidence of chronic hepatitis B