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debug_export.json
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1219 lines (1219 loc) · 35.2 KB
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{
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"text": "Dolutegravir: A Second-Generation Integrase Inhibitor for HIV Treatment",
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"text": "Human Immunodeficiency Virus continues ",
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"text": " to be a major global health challenge despite significant advances in antiretroviral therapy. Dolutegravira second-generation integrase strand transfer inhibitor has become a key component of modern HIV treatment regimens. This paper reviews the mechanism of action, pharmacokinetics, clinical efficacy, and safety profile of dolutegravir. Evidence from clinical trials demonstrates that DTG provides potent viral suppression, a high barrier to resistance, and favorable tolerability compared with earlier therapies.",
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"text": "Since the discovery of HIV, antiretroviral therapy has significantly improved the life expectancy of people living with HIV. Modern ART aims to suppress viral replication and prevent disease progression. Integrase inhibitors are a critical class of drugs because they target the HIV integrase enzyme responsible for inserting viral DNA into host cells ",
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"text": "(Everett M. Rogers et al., 2019)",
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"text": "Dolutegravir is a second-generation integrase inhibitor that is widely used in first-line HIV treatment regimens. Its high potency, once-daily dosing, and improved resistance profile distinguish it from earlier therapies ",
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"text": "Dolutegravir inhibits the ",
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"text": ", which is responsible for integrating viral DNA into the host cell genome. By blocking the strand transfer step of viral DNA integration, dolutegravir prevents viral replication and the formation of new infected cells ",
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"text": "Compared with earlier integrase inhibitors such as raltegravir, dolutegravir demonstrates stronger binding to the integrase-DNA complex and a slower dissociation rate, resulting in improved antiviral activity and a higher barrier to resistance ",
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"text": "3. Pharmacokinetics",
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"text": "Dolutegravir is administered orally and is rapidly absorbed in the body, reaching peak plasma concentration within 2–3 hours. The drug has a half-life of approximately 14 hours, enabling convenient once-daily dosing ",
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"text": "The drug is primarily metabolized through ",
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"text": ". This metabolic profile results in relatively few drug–drug interactions compared with older antiretroviral medications ",
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"text": "(Berk Hess et al., 2008)",
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"text": "4. Clinical Efficacy",
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"text": "Clinical trials have demonstrated the strong antiviral efficacy of dolutegravir-based therapies.",
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"text": " compared dolutegravir with raltegravir in treatment-naïve HIV-1 patients and found comparable rates of viral suppression after 48 weeks of treatment ",
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"text": " showed that dolutegravir achieved higher viral suppression rates than raltegravir in treatment-experienced patients with resistance to other antiretroviral drugs ",
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"text": "(M. Shoji & LHD Experiment Group, 2020)",
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"text": "Studies such as the ",
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"text": " have also shown that dolutegravir retains antiviral activity against HIV strains resistant to earlier integrase inhibitors ",
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"text": "(OliverH. Lowry et al., 1951)",
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"text": "5. Safety and Tolerability",
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"text": "Dolutegravir is generally well tolerated among patients. Common side effects reported in clinical studies include headache, nausea, and insomnia. In most cases, adverse effects are mild and rarely lead to treatment discontinuation ",
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"text": "Dolutegravir has become a cornerstone of modern HIV therapy due to its potent antiviral activity, strong resistance profile, and favorable pharmacokinetics. Its effectiveness in both treatment-naïve and treatment-experienced patients has led to widespread adoption in global treatment guidelines. Continued research will further clarify its long-term safety and role in simplified HIV treatment regimens.",
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