Immunological and Virological Outcomes among Treatment Experienced HIV-Infected Patients on Dolutegravir Regimen in Tanzania

Authors

  • Betty A. Maganda Muhimbili University of Health and Allied Sciences
  • Baraka Kivuraya Muhimbili University of Health and Allied Sciences
  • Ritah F. Mutagonda Muhimbili University of Health and Allied Sciences
  • Mary Temu Muhimbili University of Health and Allied Sciences

DOI:

https://doi.org/10.4314/tmj.v32i4.512

Keywords:

HIV, Dolutegravir, Virological-outcomes, Immunological-outcomes, Adverse drug reactions

Abstract

Introduction

The integrase inhibitor dolutegravir (DTG) has recently replaced the non-nucleoside reverse transcriptase inhibitors (efavirenz and nevirapine) in several Sub-Saharan African countries, including Tanzania. Since this change, there is scarce data on the current treatment outcomes focusing on treatment-experienced HIV-infected patients switched to DTG based regimens in Tanzania.

Objectives

This study aimed to investigate immunological and virological outcomes among treatment-experienced HIV-infected patients who were switched to DTG based regimen in Tanzania.

Results

We enrolled 397 patients, majority (65%) were female patients with mean age of 42.7 (95% CI; 40.7 – 44.7) years. The mean baseline CD4+ cell count was 457.1 (95% CI; 426.6 – 489.8) cells/mm3 with 8.3% of patients with CD4+ cell count <200 cells/mm3. The mean baseline viral load (VL) was 169.8 (95% CI; 128.8 – 223.9) copies/ml, whereby 20.6% had VL ≥ 1000 copies/ml. After the use of a new fixed dose combination of Tenofovir (TDF) 300 mg + Lamivudine (3TC) 300 mg + DTG 50 mg (TLD) for at least 24 weeks, the overall rate of virological suppression (<50 copies/ml) was 89.9% (95%CI 86.7% - 92.7%). The significant predictors of virological failure were overall duration on ART use (p = 0.004), duration on TDF + 3TC, and Efavirenz (EFV) (TLE) (p = 0.007), and baseline VL (p < 0.001).

Conclusion

TLD regimen has provided favorable preliminary results among patients who previously used TLE in HIV/AIDS treatment by showing good virological and immunological outcomes. The long-term treatment outcomes require further investigation.

Author Biographies

Betty A. Maganda, Muhimbili University of Health and Allied Sciences

Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

Baraka Kivuraya, Muhimbili University of Health and Allied Sciences

Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

Ritah F. Mutagonda, Muhimbili University of Health and Allied Sciences

Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

Mary Temu, Muhimbili University of Health and Allied Sciences

Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

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Published

2021-11-12

Issue

Section

Original Research