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Effect of dolutegravir on ferritin, iron, and C-reactive protein among people living with HIV and co-infections.
Kamurai, Bridget; Chikwati, Raylton P; Vhanda, Donald; Nyamayaro, Terrence; Manasa, Justen; Kouamou, Vinie.
Affiliation
  • Kamurai B; Department of Chemical Pathology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
  • Chikwati RP; Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Vhanda D; Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Nyamayaro T; Department of Chemical Pathology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
  • Manasa J; Department of Chemical Pathology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
  • Kouamou V; Department of Internal Medicine, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
South Afr J HIV Med ; 25(1): 1543, 2024.
Article in En | MEDLINE | ID: mdl-38725704
ABSTRACT

Background:

Dolutegravir-based antiretroviral therapy (ART) is currently recommended as the preferred first-line ART in many resource-limited settings. However, little is known about the clinical experience of dolutegravir within a context of prevalent co-infections.

Objectives:

To assess virological outcomes, and iron, ferritin and C-reactive protein (CRP) levels among people living with HIV (PLWH) and co-infections after initiating or re-initiating dolutegravir-based ART.

Method:

This prospective study was conducted between August 2022 and August 2023. Study participants were recruited from an HIV opportunistic infection clinic. Screening for co-infections (syphilis, hepatitis B virus, cytomegalovirus and herpes simplex virus) was performed at baseline, prior to ART initiation. Plasma HIV viral load (VL), CRP, ferritin and iron levels were measured at baseline and at the 6-month follow-up period.

Results:

A total of 100 participants (51 women and 49 men) were enrolled in this study. The median age of the participants was 39 years. The prevalence of co-infections was 30%. Prior to ART initiation, participants with co-infections had higher VL, CRP and ferritin, and lower iron levels, compared to those without co-infections (P < 0.001). Following 6 months of ART, CRP and ferritin levels decreased while iron levels increased, regardless of co-infection status. However, CRP and ferritin remained significantly higher in those with co-infections despite similar and high rates of virologic suppression in both groups.

Conclusion:

The presence of co-infections in PLWH is associated with higher VL and with chronic inflammation. Ferritin and CRP decreased on dolutegravir-based ART but remained higher in people with co-infections despite similar rates of virologic suppression.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: South Afr J HIV Med Year: 2024 Document type: Article Affiliation country: Zimbabwe

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: South Afr J HIV Med Year: 2024 Document type: Article Affiliation country: Zimbabwe