dc.contributor.author | McCluskey, Suzanne M. | |
dc.contributor.author | Muyindike, Winnie R. | |
dc.contributor.author | Nanfuka, Victoria | |
dc.contributor.author | Omoding, Daniel | |
dc.contributor.author | Komukama, Nimusiima | |
dc.contributor.author | Barigye, Ian T. | |
dc.contributor.author | Kansiime, Lydia | |
dc.contributor.author | Tumusiime, Justus | |
dc.contributor.author | Aung, Taing N. | |
dc.contributor.author | Stuckwisch, Ashley | |
dc.contributor.author | Hedt-Gauthier, Bethany | |
dc.contributor.author | Marconi, Vincent C. | |
dc.contributor.author | Moosa, Mahomed-Yunus S. | |
dc.contributor.author | Pillay, Deenan | |
dc.contributor.author | Giandhari, Jennifer | |
dc.contributor.author | Lessells, Richard | |
dc.contributor.author | Gupta, Ravindra K. | |
dc.contributor.author | Siedner, Mark J. | |
dc.date.accessioned | 2024-09-06T12:06:20Z | |
dc.date.available | 2024-09-06T12:06:20Z | |
dc.date.issued | 2024 | |
dc.identifier.citation | McCluskey, S. M., Muyindike, W. R., Nanfuka, V., Omoding, D., Komukama, N., Barigye, I. T., ... & Siedner, M. J. (2024). Population Effectiveness of Dolutegravir Implementation in Uganda-A Prospective Observational Cohort Study (DISCO): 48-week Results. The Journal of Infectious Diseases, jiae260. | en_US |
dc.identifier.uri | http://ir.must.ac.ug/xmlui/handle/123456789/3789 | |
dc.description.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 (<200 copies/mL) at 48 weeks. We collected blood for retrospective viral load (VL) assessment and conducted genotypic resistance tests for specimens with VL >500 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 <200 copies/mL (n = 469/500); 2% (n = 11/500) were lost from care or died; and only 2% (n = 9/500) had a VL >500 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. | en_US |
dc.description.sponsorship | National Institutes of Health (grant number K23 AI14347 | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | The Journal of Infectious Diseases | en_US |
dc.subject | HIV drug resistance | en_US |
dc.subject | Antiretroviral therapy | en_US |
dc.subject | Dolutegravir | en_US |
dc.subject | TLD | en_US |
dc.subject | Sub-Saharan Africa | en_US |
dc.title | Population Effectiveness of Dolutegravir Implementation in Uganda: A Prospective Observational Cohort Study (DISCO), 48-Week Results | en_US |
dc.type | Article | en_US |