Elizabeth Zaniewski, Veronika Whitesell Skrivankova, Ellen Brazier, Anchalee Avihingsanon, Sandra Wagner Cardoso, Carina Cesar, Henri Chenal, Brenda E Crabtree-Ramírez, Rossana A Ditangco, Peter Vanes Ebasone, Brian Eley, Jonathan George Euvrard, Geoffrey Fatti, Jacqueline Madalitso Huwa, Patricia Lelo, Daisy Maria Machado, Eugene Kouassi Messou, Albert Kla Minga, Joseph Muleebwa, Sanjay Mundhe, Gad Murenzi, Winnie R Muyindike, Dominique Mahambou Nsonde, Sarah M Obatsa, Joseph Odhiambo, Hans Walter Prozesky, Supattra Rungmaitree, Aggrey Semwendero Semeere, Moussa Seydi, Nosisa Sipambo, Tavitiya Sudjaritruk, Karl-Günter Technau, Thierry Tiendrebeogo, Christelle Twizere, Marie Ballif
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引用次数: 0
Abstract
Objective: We studied the transition to dolutegravir-containing antiretroviral therapy (ART) at HIV treatment clinics within the International epidemiology Databases to Evaluate AIDS (IeDEA).
Design: Site-level survey conducted in 2020-2021 among HIV clinics in low- and middle-income countries (LMICs).
Methods: We assessed the status of dolutegravir rollout and viral load and drug resistance testing practices for patients on ART switching to dolutegravir-based regimens. We used generalized estimating equations to assess associations between clinic rollout of both first- and second-line dolutegravir-based ART regimens (dual rollout) and site-level factors.
Results: Of 179 surveyed clinics, 175 (98%) participated; 137 (78%) from Africa, 30 (17%) from the Asia-Pacific, and 8 (5%) from Latin America. Most clinics (80%) were in low- or lower-middle-income countries, and there were a mix of primary-, secondary- and tertiary-level clinics. Ninety percent reported rollout of first-line dolutegravir, 59% of second-line, 94% of first- or second-line and 55% of dual rollout. The adjusted odds of dual rollout were higher among tertiary-level (aOR 4.00; 95% CI 1.39 to 11.47) and secondary-level clinics (aOR 3.66; 95% CI 2.19 to 6.11) than in primary-level clinics. Over half (59%) of clinics that introduced first- or second-line dolutegravir-based ART required recent viral load testing before switching to dolutegravir, and 15% performed genotypic resistance testing at switch.
Conclusions: Dolutegravir-based ART was rolled out at nearly all IeDEA clinics in LMICs, yet many switched patients to dolutegravir without recent viral load testing and drug resistance testing was rarely performed. Without such testing, drug resistance among patient switching to dolutegravir may go undetected.
期刊介绍:
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.