2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

DTG + 3TC Non-inferior to DTG + TDF/FTC: Snapshot VL <50 at Week 96

100

93.3

93.4

89.4

89.5

87.0

93.2

Snapshot

91.5

72.0

80

87.2

86.0

84.4

70.2

60

Adjusteddifference,% (95%CI) a

Treatment

Responders,n (%)

40

DTG+3TC

616/716 (86.0)

−3.4 (−6.7,0.0)

Snapshot

DTG+TDF/FTC 642/717 (89.5)

20

0

Wks

HIV-1 RNA<50 c/mL,% (95%CI) 0 4 8 12 16

24

36

48

60

72

84

96

• Notreatmentemergentresistance(INSTIorNRTI) ineitherarm • Blipsnotmorefrequent in2-drugarm. • Proportionofviralload<40/targetnot-detectedsimilarin2-and3-drugarms

Cahnetal. IAS2019;MexicoCity,Mexico. SlidesWEAB0404LB.Underwood. IAS2019.AbstrMOPEB231

Slide7of 44FromRTGandhi,MD atNewOrleans, LA,December 4-7, 2019, Ryan WhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.

Other 2-drug options for treatment of HIV

• Initial therapy ▫ DRV/r + RAL : but not as good as 3-drug therapy when CD4 <200, VL >100K 1-3 • Maintenance therapy (once VL suppressed on 3-drug therapy) ▫ DTG/RPV (SWORD) 4-5 INSTI/NNRTI ▫ LPV/r + 3TC/FTC (OLE) 6 ▫ ATV/r + 3TC (SALT, ATLAS-M) 7-8 PI + 3TC ▫ DRV/r + 3TC (DUAL) 9

1 FRaffi Lancet2014;384:1942-51; 2 Lambert-NiclotS, JAC2016; 3 Bernardino JLancetHIV.2015Nov;2(11):e464-73; 4 Llibre JMetal , Lancet,2018; 5 Aboudetal, LancetHIV,2019; 6 Arribas JRetal, Lancet ID,2015; 7 Perez-Molina JAetal, Lancet ID,2015; 8 DiGiambenedettoSetal, JAntimicrobChemother 2017; 9 PulidoTHIVDrugTherapy 2016Glasgow,O331

Slide8of 44FromRTGandhi,MD atNewOrleans, LA,December 4-7, 2019, Ryan WhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.

Emerging and investigational 2-drug options for treatment of HIV

• Initial therapy ▫ DRV/r + 3TC (ANDES): promising in small randomized trial 1 ▫ Islatravir + Doravirine: investigational • Second-line therapy ▫ DRV/r + DTG (vs. 2 NRTI + DRV/r or DTG) (D2EFT). N=1010. Ongoing. 2 • Maintenance therapy (once VL suppressed on 3-drug therapy) ▫ DRV/r + RPV (n=60) 3 ▫ DRV/r + DTG (DUALIS): similar 48 wk results as 3-drug therapy (n=265) 4 ▫ LA Cabotegravir/Rilpivirine (ATLAS, FLAIR, ATLAS-2M)

1 Figueroa,CROI2018,abstract489; 2 clinicaltrials.gov #NCT03017872 3 MaggioloF, JAIDS,2016; 4 Spinner, IAS2019,abstractMOPEB269

Slide9of 44FromRTGandhi,MD atNewOrleans, LA,December 4-7, 2019, Ryan WhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.