1564. Virological Suppression in People with HIV-1 (PWH) Receiving Dolutegravir/Lamivudine Was High and Similar across Age Groups despite Older PWH Having Increased Rates of Comorbidities and Polypharmacy (TANDEM Subgroup Analysis)

Eligible PWH were adults initiating dolutegravir/lamivudine prior to September 30, 2020, with ≥6 months of clinical follow-up (Figure 1). Stable-switch PWH were defined as having HIV-1 RNA < 50 copies/mL and on a stable antiretroviral regimen for ≥3 months upon dolutegravir/lamivudine initiation. Clinical characteristics, treatment history, and outcomes were analyzed for 3 age groups among dolutegravir/lamivudine stable-switch PWH. Analyses were descriptive.

The number of dolutegravir/lamivudine stable-switch PWH in each age group was 86 (< 50 years), 106 (≥50 years), and 20 (≥65 years). A greater proportion of PWH in the older age groups were female sex at birth (14.0% < 50 years; 20.8% ≥50 years; 30.0% ≥65 years). More PWH in older age groups had reported comorbidity (12.8% < 50 years; 34.9% ≥50 years; 45.0% ≥65 years) and polypharmacy (5.8% < 50 years; 17.9% ≥50 years; 30.0% ≥65 years; Figure 2). Avoidance of long-term toxicities was the biggest driver for initiating dolutegravir/lamivudine in the older age groups (32.1% ≥50 years; 30.0% ≥65 years) while simplification/streamlining of treatment was the most common (27.9%) primary reason for PWH to switch to dolutegravir/lamivudine in the < 50 years group (Figure 3). For PWH < 50 years, 95.3% remained virologically suppressed for the study period. Similarly, 96.2% of PWH ≥50 years and 95.0% of PWH ≥65 years remained virologically suppressed for the study period (Figure 4). Three PWH with nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) resistance at baseline remained suppressed.