Population Effectiveness of Dolutegravir Implementation in Uganda: A Prospective Observational Cohort Study (DISCO), 48-Week Results.
J Infect Dis
; 230(3): e622-e630, 2024 Sep 23.
Article
in En
| MEDLINE
| ID: mdl-38748986
ABSTRACT
BACKGROUND:
Tenofovir/lamivudine/dolutegravir (TLD) is the preferred first-line antiretroviral therapy (ART) regimen for people with HIV (PWH), including those who were previously virologically suppressed on nonnucleoside reverse transcriptase inhibitors (NNRTIs). We sought to estimate the real-world effectiveness of the TLD transition in Ugandan public-sector clinics.METHODS:
We conducted a prospective cohort study of PWH aged ≥18 years who were transitioned from NNRTI-based ART to TLD. Study visits were conducted on the day of TLD transition and 24 and 48 weeks later. The primary end point was viral suppression (<200â copies/mL) at 48 weeks. We collected blood for retrospective viral load (VL) assessment and conducted genotypic resistance tests for specimens with VL >500â copies/mL.RESULTS:
We enrolled 500 participants (median age 47 years; 41% women). At 48 weeks after TLD transition, 94% of participants were in care with a VL <200â copies/mL (n = 469/500); 2% (n = 11/500) were lost from care or died; and only 2% (n = 9/500) had a VL >500â copies/mL. No incident resistance to DTG was identified. Few participants (2%, n = 9/500) discontinued TLD due to adverse events.CONCLUSIONS:
High rates of viral suppression, high tolerability, and lack of emergent drug resistance support use of TLD as the preferred first-line regimen in the region. CLINICAL TRIALS REGISTRATION NCT04066036.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Oxazines
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Piperazines
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Pyridones
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HIV Infections
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Anti-HIV Agents
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Viral Load
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Heterocyclic Compounds, 3-Ring
Limits:
Adult
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Female
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Humans
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Male
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Middle aged
Country/Region as subject:
Africa
Language:
En
Journal:
J Infect Dis
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J. infect. dis
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Journal of infectious diseases
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: