DTV 50 Special Precautions

While effective viral suppression with antiretroviral therapy has been proven to substantially reduce the risk of sexual transmission, a residual risk cannot be excluded. Precautions to prevent transmission should be taken in accordance with national guidelines.
The decision to use DTV 50 in the presence of integrase class resistance should take into account that the activity of DTV 50 is considerably compromised for viral strains harbouring Q148+>2 secondary mutations from G140A/C/S, E138A/K/T, L74I.
Hypersensitivity reactions have been reported with DTV 50, and were characterized by rash, constitutional findings, and sometimes, organ dysfunction, including severe liver reactions. DTV 50 and other suspect agents should be discontinued immediately if signs or symptoms of hypersensitivity reactions develop.
Clinical status including liver aminotransferases and bilirubin should be monitored. Delay in stopping treatment with DTV 50 or other suspect active substances after the onset of hypersensitivity may result in a life-threatening allergic reaction.
In HIV-infected patients with severe immune deficiency at the time of institution of combination antiretroviral therapy (CART), an inflammatory reaction to asymptomatic or residual opportunistic pathogens may arise and cause serious clinical conditions, or aggravation of symptoms. Any inflammatory symptoms should be evaluated and treatment instituted when necessary.
Monitoring of liver biochemistries is recommended in some hepatitis B and/or C co-infected patients at the start of DTV 50 therapy. Particular diligence should be applied in initiating or maintaining effective hepatitis B therapy when starting DTV 50-based therapy in hepatitis B co-infected patients.
Patients should remain under close clinical observation by physicians experienced in the treatment of the associated HIV diseases like opportunistic infections.
Patients with advanced HIV-disease and/or long-term exposure to CART should be advised to seek medical advice if they experience joint aches and pain, joint stiffness or difficulty in movement.