Publication: Virologic Response Following a Switch to Dolutegravir-based Regimen in People Living with HIV/AIDS at a Tertiary Care Center in Nepal
Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
The dolutegravir-based antiretroviral regimen is the preferred first-line regimen
for the management of people living with human immunodeficiency virus in Nepal
recently. It is considered safe to transition to a dolutegravir-based regimen for
children and adults on Nevirapine and Efavirenz-based regimens.
Objective
To determine the virologic response following the transition to a Dolutegravir-based
regimen in people living with human immunodeficiency virus previously taking
Nevirapine and Efavirenz-based regimen.
Method
This is a retrospective cohort study including people living with human
immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS) who were
transitioned to Tenofovir/Lamivudine/Dolutegravir previously on other antiretroviral
therapy regimens for at least 6 months and who had their viral load test done before
transition. The medical records of patients were reviewed from records available at
the antiretroviral therapy clinic of Dhulikhel Hospital. The viral load done at least 3
months after switching to the Dolutegravir-based regimen was recorded. Descriptive
analysis of socio-demographic and clinical characteristics data was done.
Result
Fifty-seven people living with human immunodeficiency virus/ acquired
immunodeficiency syndrome who transitioned to a Dolutegravir-based regimen
previously on other antiretroviral therapy regimens for at least 6 months were
included in this study. Tenofovir/Lamivudine/Efavirenz (47.4%), Zidovudine/
Lamivudine/Nevirapine (22.8%) and Zidovudine/Lamivudine/Efavirenz (17.5%)
were the most common antiretroviral regimens before transition. The majority of
the patients (86%) had suppressed viral load of fewer than 40 copies/mL before the
switch. Following the transition, 96.5% of the patients had suppressed viral load of
fewer than 40 copies/mL.
Conclusion
Dolutegravir-based antiretroviral regimen led to untransmittable viral load following
a switch from Nevirapine and Efavirenz-based regimen.
KEY WORDS
Antiretroviral therapy, Dolutegravir, Human immunodeficiency virus, Viral load
Description
Tamrakar R,1 Tamrakar D2
1Department of Internal Medicine
2Department of Community Medicine
Dhulikhel Hospital, Kathmandu University Hospital,
Kathmandu University School of Medical Sciences,
Dhulikhel, Kavre, Nepal
Keywords
Antiretroviral therapy, Dolutegravir, Human immunodeficiency virus, Viral load