November, 2015 –At least three B.C. patients have developed new integrase resistance mutations affecting dolutegravir and/or raltegravir and elvitegravir which emerged during treatment with dolutegravir 50 mg daily plus abacavir-lamivudine. Two of the three patients also developed new resistance to lamivudine and abacavir. One patient was treatment naïve and two were treatment experienced. None had previously documented drug resistance. Two of these patients achieved virologic suppression followed by rebound, while one never achieved a viral load <40 c/mL. Drug resistance emerged within 8-12 months after starting the dolutegravir-based regimen. Incomplete medication adherence appeared to be a contributing factor.
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