CONCLUSIONS
The ARTIST study provides additional evidence that maintaining tenofovir and lamivudine with dolutegravir is effective and well tolerated in second-line ART. Our results provide evidence over 24 weeks that patients with unsuppressed HIV-1 RNA levels on first-line TEE can safely switch to second-line TLD without a lead-in supplementary dolutegravir dose to overcome efavirenz induction—however, it is possible that resistance will emerge at later timepoints.