Adherence, resistance, and viral suppression on dolutegravir in sub-Saharan Africa: implications for the TLD era. (15th December 2021)

• Record Type: Journal Article
• Authors: McCluskey, Suzanne M.; Pepperrell, Toby; Hill, Andrew; Venter, Willem D.F.; Gupta, Ravindra K.; Siedner, Mark J.
• Is Part Of: AIDS. Volume 35:Supplement 2(2021)
• Publication Date: 2021-12-15
• Subjects: dolutegravir -- drug resistance -- HIV-1 -- integrase strand transfer inhibitors -- sub-Saharan Africa -- treatment adherence; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000003082
• Languages: English
• ISSNs: 0269-9370

Abstract

Abstract : N/A: Dolutegravir (DTG) is now a component of preferred first-line antiretroviral therapy (ART) worldwide. ADVANCE and NAMSAL were two landmark clinical trials conducted exclusively in sub-Saharan Africa, which studied the effectiveness of DTG-based first-line regimens for ART-naive individuals. In this review, we examine the data from these studies to consider the contributions of adherence and HIV drug resistance to treatment failure on DTG-based ART, as compared with efavirenz (EFV)-based ART, which has a lower genetic barrier to resistance. We also discuss the implications of virologic failure on DTG and consolidate currently available data to conclude with recommendations for virologic monitoring on DTG-based ART.