{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:31:02Z","timestamp":1787758262206,"version":"build-2784847793"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the effectiveness of dolutegravir\/lamivudine (DTG\/3TC) versus bictegravir\/emtricitabine\/tenofovir alafenamide (BIC\/FTC\/TAF) at Week 48 in treatment-naive adults with high baseline viral loads (\u2265500\u200a000\u2005copies\/mL) and CD4+ cell count \u2265200\/mm3 and to assess immune recovery and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single-centre retrospective cohort study including all ART-naive people with HIV-1 (PWH) and HIV-RNA \u2265500\u200a000\u2005copies\/mL and CD4+ \u2265200\u2005cells\/mm3 who initiated DTG\/3TC or BIC\/FTC\/TAF during 2019\u20132024. Effectiveness was assessed as the proportion of participants achieving HIV-1 RNA &amp;lt;50\u2005copies\/mL at Week 48 [intention-to-treat, missing\u200a=\u200afailure (ITT, M\u200a=\u200aF)]. Immune recovery, metabolic and renal safety were evaluated through changes in CD4+ count, weight, lipid profile and creatinine. Time-to-virologic suppression was analysed using Kaplan\u2013Meier curves and log-rank testing. Safety profile and immune recovery were conducted using Mann\u2013Whitney U test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 40 patients (52.5% on DTG\/3TC, 47.5% on BIC\/FTC\/TAF) were included, with a high prevalence of primary HIV infection (PHI) (76.2% and 84.2%, respectively). No baseline differences were observed between groups. At 48\u2005weeks, virologic suppression rates were 90.5% (19\/21) in the DTG\/3TC group and 94.7% (18\/19) in the BIC\/FTC\/TAF group (log-rank P\u200a=\u200a0.73). Viral decay kinetics were similar between groups. No virologic failures with resistance or treatment discontinuations were observed. Median CD4+ gains were comparable between groups (385 vs 243\u2005cells\/mm3; P\u200a=\u200a0.30). No significant differences in weight gain, lipid profile, or creatinine levels were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In ART-naive PWH with HIV-RNA \u2265500\u200a000\u2005cp\/mL and CD4+ \u2265200\/mm3, including those with PHI, DTG\/3TC and BIC\/FTC\/TAF showed similar effectiveness and comparable safety profiles at Week 48.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag285","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T11:47:06Z","timestamp":1785930426000},"source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of dolutegravir\/lamivudine versus bictegravir\/emtricitabine\/tenofovir alafenamide in people with HIV with very high viral load (\u2265500\u200a000\u2005copies\/mL)"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9783-1147","authenticated-orcid":false,"given":"Juan","family":"Martin-Torres","sequence":"first","affiliation":[{"name":"HIV Unit, Medicine Department, University Hospital 12 de Octubre, imas12 , Glorieta M\u00e1laga 11, Madrid 28041 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7044-2707","authenticated-orcid":false,"given":"Roser","family":"Navarro-Soler","sequence":"additional","affiliation":[{"name":"HIV Unit, Medicine Department, University Hospital 12 de Octubre, imas12 , Glorieta M\u00e1laga 11, Madrid 28041 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Iglesias-Franco","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, University Hospital La Princesa , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Lagarde-Sebasti\u00e1n","sequence":"additional","affiliation":[{"name":"HIV Unit, Medicine Department, University Hospital 12 de Octubre, imas12 , Glorieta M\u00e1laga 11, Madrid 28041 ,","place":["Spain"]},{"name":"Centre for Biomedical Research in Infectious Diseases Network, CIBER of Infectious Diseases (CIBERINFEC) , Madrid ,","place":["Spain"]},{"name":"Medicine Department, Complutense University of Madrid , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otilia","family":"Bisbal-Pardo","sequence":"additional","affiliation":[{"name":"HIV Unit, Medicine Department, University Hospital 12 de Octubre, imas12 , Glorieta M\u00e1laga 11, Madrid 28041 ,","place":["Spain"]},{"name":"Centre for Biomedical Research in Infectious Diseases Network, CIBER of Infectious Diseases (CIBERINFEC) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9951-712X","authenticated-orcid":false,"given":"David","family":"Rial-Crestelo","sequence":"additional","affiliation":[{"name":"HIV Unit, Medicine Department, University Hospital 12 de Octubre, imas12 , Glorieta M\u00e1laga 11, Madrid 28041 ,","place":["Spain"]},{"name":"Centre for Biomedical Research in Infectious Diseases Network, CIBER of Infectious Diseases (CIBERINFEC) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Pinto-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"HIV Unit, Medicine Department, University Hospital 12 de Octubre, imas12 , Glorieta M\u00e1laga 11, Madrid 28041 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Bel\u00e9n","family":"S\u00e1nchez-L\u00f3pez","sequence":"additional","affiliation":[{"name":"HIV Unit, Medicine Department, University Hospital 12 de Octubre, imas12 , Glorieta M\u00e1laga 11, Madrid 28041 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireia","family":"Santacreu","sequence":"additional","affiliation":[{"name":"HIV Unit, Medicine Department, University Hospital 12 de Octubre, imas12 , Glorieta M\u00e1laga 11, Madrid 28041 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Bermejo","sequence":"additional","affiliation":[{"name":"HIV Unit, Medicine Department, University Hospital 12 de Octubre, imas12 , Glorieta M\u00e1laga 11, Madrid 28041 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1901-1119","authenticated-orcid":false,"given":"Asunci\u00f3n","family":"Hernando","sequence":"additional","affiliation":[{"name":"HIV Unit, Medicine Department, University Hospital 12 de Octubre, imas12 , Glorieta M\u00e1laga 11, Madrid 28041 ,","place":["Spain"]},{"name":"Centre for Biomedical Research in Infectious Diseases Network, CIBER of Infectious Diseases (CIBERINFEC) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Rubio","sequence":"additional","affiliation":[{"name":"HIV Unit, Medicine Department, University Hospital 12 de Octubre, imas12 , Glorieta M\u00e1laga 11, Madrid 28041 ,","place":["Spain"]},{"name":"Centre for Biomedical Research in Infectious Diseases Network, CIBER of Infectious Diseases (CIBERINFEC) , Madrid ,","place":["Spain"]},{"name":"Medicine Department, Complutense University of Madrid , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7414-8812","authenticated-orcid":false,"given":"Federico","family":"Pulido","sequence":"additional","affiliation":[{"name":"HIV Unit, Medicine Department, University Hospital 12 de Octubre, imas12 , Glorieta M\u00e1laga 11, 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