1. New/Optimal ARV Treatments Why ? & How
A more effective response to HIV/AIDS The Role of Value For Money
New/Optimal ARV Treatments Why ? & How
Pr Eric Delaporte
Dr Charles Kouanfack
IAS Paris 2017

2. Why? Universal Access to ART
Suboptimal results whith the actual first line
Low genetic barrier and increasing HIV resistance to ART
≈ 80%
≈ 60%
T. Sonia Boender et al.
IAS Paris 2017

3. How Alternative DTG High genetic barrier Better tolerance
Cheap and simple
Superior or equivalent to different first-line regimens
(SPRING-1, SINGLE, FLAMINGO, SPRING-2)
Safe and effective
Tolerable
One pill, once a day, heat stable
 Simple
High genetic barrier to resistance
 Durable
Few drug-drug interactions
 Universal
Low manufacturing cost (50 mg), favorable market landscape
 Affordable
2015
2016
2017
DTG , TAF
TAF/FTC approved
Cobisistat (booster) DRV/Cobi ATV/Cobi
DTG for childrens
Lond drug Active: Cabotegravir, rilpirivine. Plus…
IAS Paris 2017

4. Benefits What is needed?
FDC of Dolutegravir (DTG)/XTC/TDF) : cheaper and better tolerate than the actual first line (generic is available)
Still more cheap and better tolerate if maintenance strategy DTG/XTC is validited
Less expensive second line
Prevent the emergence of HIV resistance
Impact on HIV monitoring?
Evaluation in real-world conditions within resources-constrained settings is needed to support the recommendation of a DTG- or EFV400-based regimen as preferred first-line regimen
Targeted drug-drug interaction PK studies with rifampicin (TB treatment)
Additional information on safety in pregnant women Key studies:ANRS/UNITAID NAMSAL study
UNITAID ADVANCE Study
UNITAID DolPHIN2
IAS Paris 2017

5. Thank you for your attention
IAS Paris 2017