Etude de simplification de traitement par bithérapie de dolutégravir + emtricitabine et de décentralisation du suivi de traitement chez les personnes porteuses du VIH et avirémiques sous thérapie antirétrovirale conventionnelle

Drug: Switch to DTG + FTC;Other: Patient-centered monitoring

Inclusion Criteria:

1. Informed consent as documented by signature;

2. Documented HIV-1 infection;

3. Enrolled in the Swiss HIV Cohorte Study (SHCS) or receiving care from a medical doctor
of the SHCS network;

4. = 18 years of age;

5. HIV-RNA <50 copies/mL at screening and for at least 24 weeks before screening on
effective suppressive cART, one blip with less than 200 copies/mL being allowed during
this period if followed by at least 2 results < 50 copies/mL.

6. On standard cART at the time of inclusion, i.e.:

- 2 NRTIs + either 1 NNRTI, 1 boosted PI or 1 INSTI;

- NRTI-sparing triple ARV regimen (e.g. 1 NRTI + 1 NNRTI + 1 InSTI);

- Dual therapy with protease inhibitor.

Exclusion Criteria:

1. HIV-2 infection;

2. Previous ART change for unsatisfactory virological response, i.e. slow initial
virological suppression, incomplete suppression or rebound. Change of drug or drug
class for convenience or toxic effect prevention or management is allowed.

Note: patients with documented genotype(s) presenting only a M184V mutation remain
eligible;

3. Creatinine clearance < 50ml/min;

4. ASAT or ALAT >2.5x upper limit of the norm;

5. Known hypersensitivity, intolerance or allergy to DTG or FTC;

6. Known or suspected non-adherence (defined as <80% adherence, i.e. missed doses >
1x/week) to current treatment in the last 6 months;

7. Concomitant use of drugs that decrease DTG blood concentrations including
carbamazepine, oxcarbamazepine, phenytoin, phenobarbital, St John's wort and
rifampicin;

8. Women who are pregnant or breast-feeding;

9. a. Presence of any INSTI-resistance. Non-availability of INSTI resistance testing is
NOT an exclusion criteria.

b. Non availability of previous routine resistance test, at least for reverse
transcriptase and protease genes.

Note: Subjects remain eligible in the absence of any previous resistance test only if
they are on their first-line antiretroviral regimen;

10. Evidence of acute or chronic hepatitis B virus infection based on results of serology
testing.