2DR Versus 3DR in a Prospective Randomized Controlled Switch Trial
Trial Parameters
Brief Summary
The aim of this study is to monitor virological and immunological markers in participants who are switching from a classic triple drug regimen (3DR) to dual therapy (2DR). We aim to monitor whether this has an influence on different parameters such as severity of HIV disease (evaluated by viral load and viral reservoir size), presence of non-AIDS related health complications, impact the phenotype and function of the immune system. By conducting this study we want to assess whether switching from 3DR to 2DR implies an increased risk for 'subclinical' failure. We especially want to make sure that this switch does not increase the HIV reservoir, does not increase inflammation or immune exhaustion in patients living with HIV and that it can be considered as a safe long term alternative for the classic 3DR. The primary objective is to demonstrate non inferiority at W48 of the 2DR DTG/3TC (Dovato) regimen compared to BIC/TAF/FTC (Biktarvy) in terms of the amount of intact replication competent HIV sequences with a non-inferiority margin of 12% quantified by the fraction intact HIV viral sequences quantified by an intact proviral DNA assay, present in blood CD4 cells.
Eligibility Criteria
Inclusion Criteria: * Age = or \>18 years. * Ability and willingness to provide written informed consent. * Ability to attend the complete schedule of assessments and patient visits. * Ability and willingness to have blood samples collected and stored indefinitely and used for various research purposes. * HIV RNA \< 50 copies/mL for at least 3 months on a 2nd generation INSTI based regimen. * Females of childbearing potential should be on effective contraception Exclusion Criteria: * Current presence of opportunistic infection (AIDS defining events as defined in category C of the CDC clinical classification). * Evidence of active HBV infection (Hepatitis B surface antigen positive or HBV viral load positive in the past and no evidence of subsequent seroconversion (seroconversion= HBV antigen or viral load negative and positive HBV surface antibody). * Evidence of active HCV infection: HCV antibody positive result within 60 days prior to study entry with positive HCV viral load or, if t