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Brief communication: Long-term treatment outcomes of transitioning to dolutegravir-based ART from efavirenz in HIV study participants in Mbeya, Tanzania
The World Health Organization recommends dolutegravir-based antiretroviral therapy (ART) as the preferred first-line regimen for HIV treatment. This retrospective cohort study evaluated the long-term virologic outcomes and safety of transitioning from an efavirenz-based regimen (tenofovir, lamivudin...
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| Published in: | AIDS research and therapy 2024-12, Vol.21 (1), p.98-6, Article 98 |
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| container_title | AIDS research and therapy |
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| creator | Majula, Revocatus T Mweya, Clement N |
| description | The World Health Organization recommends dolutegravir-based antiretroviral therapy (ART) as the preferred first-line regimen for HIV treatment. This retrospective cohort study evaluated the long-term virologic outcomes and safety of transitioning from an efavirenz-based regimen (tenofovir, lamivudine, efavirenz [TLE]) to a dolutegravir-based regimen (tenofovir, lamivudine, dolutegravir [TLD]) among adult HIV participants in Mbeya, Tanzania.
Medical records of 250 adult HIV participants who transitioned from TLE to TLD at Mbeya Zonal Referral Hospital were reviewed from August 2022 to December 2022. The primary outcome was virologic failure, defined as HIV RNA > 1000 copies/mL. Secondary outcomes included viral suppression ( |
| doi_str_mv | 10.1186/s12981-024-00662-z |
| format | article |
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Medical records of 250 adult HIV participants who transitioned from TLE to TLD at Mbeya Zonal Referral Hospital were reviewed from August 2022 to December 2022. The primary outcome was virologic failure, defined as HIV RNA > 1000 copies/mL. Secondary outcomes included viral suppression (< 50 copies/mL) and adverse drug reactions (ADRs). Using appropriate statistical tests, participant characteristics and outcomes were compared before and six months after transitioning.
At baseline on TLE, 88% had viral suppression, and 3.6% had virologic failure. Six months after transitioning to TLD, viral suppression was 87.2% and virologic failure increased to 6.8%. Overall, 79.6% experienced ADRs with TLD, predominantly neurological effects and weight gain. No significant associations were found between viral load changes and participant characteristics like age, sex or treatment duration.
Transitioning to dolutegravir maintained high rates of viral suppression comparable to efavirenz, albeit with a slight increase in virologic failure. Dolutegravir was well-tolerated overall despite a high ADR rate. Findings support the ongoing scale-up of dolutegravir in Tanzania and other resource-limited settings while highlighting the need for continued viral load monitoring and pharmacovigilance.</description><identifier>ISSN: 1742-6405</identifier><identifier>EISSN: 1742-6405</identifier><identifier>DOI: 10.1186/s12981-024-00662-z</identifier><identifier>PMID: 39716209</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adult ; AIDS treatment ; Alkynes ; Anti-HIV agents ; Anti-HIV Agents - adverse effects ; Anti-HIV Agents - therapeutic use ; Antiviral agents ; Benzoxazines - adverse effects ; Benzoxazines - therapeutic use ; Biological products industry ; Complications and side effects ; Cyclopropanes ; Dolutagravir-based antiretroviral therapy ; Dosage and administration ; Drug therapy ; Efavirenz ; Efavirenz-based antiretroviral therapy ; Female ; Heterocyclic Compounds, 3-Ring - adverse effects ; Heterocyclic Compounds, 3-Ring - therapeutic use ; Highly active antiretroviral therapy ; HIV (Viruses) ; HIV Infections - drug therapy ; HIV-1 - drug effects ; HIV-infected study participants ; Humans ; Lamivudine - therapeutic use ; Male ; Medical records ; Middle Aged ; Oxazines - therapeutic use ; Patient compliance ; Patient outcomes ; Pharmacology, Experimental ; Physiological aspects ; Piperazines - therapeutic use ; Pyridones - therapeutic use ; Retrospective evaluation ; Retrospective Studies ; Tanzania ; Tenofovir - therapeutic use ; Treatment Outcome ; Treatment outcomes ; Viral Load - drug effects</subject><ispartof>AIDS research and therapy, 2024-12, Vol.21 (1), p.98-6, Article 98</ispartof><rights>2024. The Author(s).</rights><rights>COPYRIGHT 2024 BioMed Central Ltd.</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3536-a17b72b1661a073c75243cae535c06a6ca4944eee2ab3ab444b08b9731c81fb53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667906/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667906/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27922,27923,37011,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39716209$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Majula, Revocatus T</creatorcontrib><creatorcontrib>Mweya, Clement N</creatorcontrib><title>Brief communication: Long-term treatment outcomes of transitioning to dolutegravir-based ART from efavirenz in HIV study participants in Mbeya, Tanzania</title><title>AIDS research and therapy</title><addtitle>AIDS Res Ther</addtitle><description>The World Health Organization recommends dolutegravir-based antiretroviral therapy (ART) as the preferred first-line regimen for HIV treatment. This retrospective cohort study evaluated the long-term virologic outcomes and safety of transitioning from an efavirenz-based regimen (tenofovir, lamivudine, efavirenz [TLE]) to a dolutegravir-based regimen (tenofovir, lamivudine, dolutegravir [TLD]) among adult HIV participants in Mbeya, Tanzania.
Medical records of 250 adult HIV participants who transitioned from TLE to TLD at Mbeya Zonal Referral Hospital were reviewed from August 2022 to December 2022. The primary outcome was virologic failure, defined as HIV RNA > 1000 copies/mL. Secondary outcomes included viral suppression (< 50 copies/mL) and adverse drug reactions (ADRs). Using appropriate statistical tests, participant characteristics and outcomes were compared before and six months after transitioning.
At baseline on TLE, 88% had viral suppression, and 3.6% had virologic failure. Six months after transitioning to TLD, viral suppression was 87.2% and virologic failure increased to 6.8%. Overall, 79.6% experienced ADRs with TLD, predominantly neurological effects and weight gain. No significant associations were found between viral load changes and participant characteristics like age, sex or treatment duration.
Transitioning to dolutegravir maintained high rates of viral suppression comparable to efavirenz, albeit with a slight increase in virologic failure. Dolutegravir was well-tolerated overall despite a high ADR rate. Findings support the ongoing scale-up of dolutegravir in Tanzania and other resource-limited settings while highlighting the need for continued viral load monitoring and pharmacovigilance.</description><subject>Adult</subject><subject>AIDS treatment</subject><subject>Alkynes</subject><subject>Anti-HIV agents</subject><subject>Anti-HIV Agents - adverse effects</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiviral agents</subject><subject>Benzoxazines - adverse effects</subject><subject>Benzoxazines - therapeutic use</subject><subject>Biological products industry</subject><subject>Complications and side effects</subject><subject>Cyclopropanes</subject><subject>Dolutagravir-based antiretroviral therapy</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Efavirenz</subject><subject>Efavirenz-based antiretroviral therapy</subject><subject>Female</subject><subject>Heterocyclic Compounds, 3-Ring - adverse effects</subject><subject>Heterocyclic Compounds, 3-Ring - therapeutic use</subject><subject>Highly active antiretroviral therapy</subject><subject>HIV (Viruses)</subject><subject>HIV Infections - drug therapy</subject><subject>HIV-1 - drug effects</subject><subject>HIV-infected study participants</subject><subject>Humans</subject><subject>Lamivudine - therapeutic use</subject><subject>Male</subject><subject>Medical records</subject><subject>Middle Aged</subject><subject>Oxazines - therapeutic use</subject><subject>Patient compliance</subject><subject>Patient outcomes</subject><subject>Pharmacology, Experimental</subject><subject>Physiological aspects</subject><subject>Piperazines - therapeutic use</subject><subject>Pyridones - therapeutic use</subject><subject>Retrospective evaluation</subject><subject>Retrospective Studies</subject><subject>Tanzania</subject><subject>Tenofovir - therapeutic use</subject><subject>Treatment Outcome</subject><subject>Treatment outcomes</subject><subject>Viral Load - drug effects</subject><issn>1742-6405</issn><issn>1742-6405</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNptktFqFDEUhgdRbK2-gBcSEETBqckkk5nxRmpRu1hRZPU2nMmcmabMJGuSKXafxMc1u1tLFyQXCed858_P4c-yp4weM1bLN4EVTc1yWoicUimLfH0vO2SVKHIpaHn_zvsgexTCJaVcFqx8mB3wpmKyoM1h9ue9N9gT7aZptkZDNM6-JefODnlEP5HoEeKENhI3x0RhIK5PVbDBbFhjBxId6dw4Rxw8XBmftxCwIyffl6T3biLYb6po18RYcrb4SUKcu2uyAh-NNiuwMWw6X1q8htdkCXYN1sDj7EEPY8AnN_dR9uPjh-XpWX7-9dPi9OQ817zkMgdWtVXRMikZ0IrrqiwE14AlLzWVIDWIRghELKDl0AohWlq3TcWZrlnflvwoW-x0OweXauXNBP5aOTBqW3B-UFujIyrOmk6UvKbQdwI0S3-zssVCN9BKEJi03u20VnM7YafT2jyMe6L7HWsu1OCuFEv-q4bKpPDyRsG7XzOGqCYTNI4jWHRzSBZEXQvW1HVCn-_QAZI3Y3uXJPUGVyd1wRiveV0k6vg_VDodTkY7i71J9b2BV3sDiYn4Ow4wh6A-f1vssy_usBcIY7wImySkYIR9sNiB2rsQPPa3O2FUbbKsdllWKctqm2W1TkPP7m7zduRfePlf6ezwFg</recordid><startdate>20241223</startdate><enddate>20241223</enddate><creator>Majula, Revocatus T</creator><creator>Mweya, Clement N</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>KPI</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20241223</creationdate><title>Brief communication: Long-term treatment outcomes of transitioning to dolutegravir-based ART from efavirenz in HIV study participants in Mbeya, Tanzania</title><author>Majula, Revocatus T ; Mweya, Clement N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-a17b72b1661a073c75243cae535c06a6ca4944eee2ab3ab444b08b9731c81fb53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>AIDS treatment</topic><topic>Alkynes</topic><topic>Anti-HIV agents</topic><topic>Anti-HIV Agents - adverse effects</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiviral agents</topic><topic>Benzoxazines - adverse effects</topic><topic>Benzoxazines - therapeutic use</topic><topic>Biological products industry</topic><topic>Complications and side effects</topic><topic>Cyclopropanes</topic><topic>Dolutagravir-based antiretroviral therapy</topic><topic>Dosage and administration</topic><topic>Drug therapy</topic><topic>Efavirenz</topic><topic>Efavirenz-based antiretroviral therapy</topic><topic>Female</topic><topic>Heterocyclic Compounds, 3-Ring - adverse effects</topic><topic>Heterocyclic Compounds, 3-Ring - therapeutic use</topic><topic>Highly active antiretroviral therapy</topic><topic>HIV (Viruses)</topic><topic>HIV Infections - drug therapy</topic><topic>HIV-1 - drug effects</topic><topic>HIV-infected study participants</topic><topic>Humans</topic><topic>Lamivudine - therapeutic use</topic><topic>Male</topic><topic>Medical records</topic><topic>Middle Aged</topic><topic>Oxazines - therapeutic use</topic><topic>Patient compliance</topic><topic>Patient outcomes</topic><topic>Pharmacology, Experimental</topic><topic>Physiological aspects</topic><topic>Piperazines - therapeutic use</topic><topic>Pyridones - therapeutic use</topic><topic>Retrospective evaluation</topic><topic>Retrospective Studies</topic><topic>Tanzania</topic><topic>Tenofovir - therapeutic use</topic><topic>Treatment Outcome</topic><topic>Treatment outcomes</topic><topic>Viral Load - drug effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Majula, Revocatus T</creatorcontrib><creatorcontrib>Mweya, Clement N</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Global Issues</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>AIDS research and therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Majula, Revocatus T</au><au>Mweya, Clement N</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brief communication: Long-term treatment outcomes of transitioning to dolutegravir-based ART from efavirenz in HIV study participants in Mbeya, Tanzania</atitle><jtitle>AIDS research and therapy</jtitle><addtitle>AIDS Res Ther</addtitle><date>2024-12-23</date><risdate>2024</risdate><volume>21</volume><issue>1</issue><spage>98</spage><epage>6</epage><pages>98-6</pages><artnum>98</artnum><issn>1742-6405</issn><eissn>1742-6405</eissn><abstract>The World Health Organization recommends dolutegravir-based antiretroviral therapy (ART) as the preferred first-line regimen for HIV treatment. This retrospective cohort study evaluated the long-term virologic outcomes and safety of transitioning from an efavirenz-based regimen (tenofovir, lamivudine, efavirenz [TLE]) to a dolutegravir-based regimen (tenofovir, lamivudine, dolutegravir [TLD]) among adult HIV participants in Mbeya, Tanzania.
Medical records of 250 adult HIV participants who transitioned from TLE to TLD at Mbeya Zonal Referral Hospital were reviewed from August 2022 to December 2022. The primary outcome was virologic failure, defined as HIV RNA > 1000 copies/mL. Secondary outcomes included viral suppression (< 50 copies/mL) and adverse drug reactions (ADRs). Using appropriate statistical tests, participant characteristics and outcomes were compared before and six months after transitioning.
At baseline on TLE, 88% had viral suppression, and 3.6% had virologic failure. Six months after transitioning to TLD, viral suppression was 87.2% and virologic failure increased to 6.8%. Overall, 79.6% experienced ADRs with TLD, predominantly neurological effects and weight gain. No significant associations were found between viral load changes and participant characteristics like age, sex or treatment duration.
Transitioning to dolutegravir maintained high rates of viral suppression comparable to efavirenz, albeit with a slight increase in virologic failure. Dolutegravir was well-tolerated overall despite a high ADR rate. Findings support the ongoing scale-up of dolutegravir in Tanzania and other resource-limited settings while highlighting the need for continued viral load monitoring and pharmacovigilance.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>39716209</pmid><doi>10.1186/s12981-024-00662-z</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | AIDS research and therapy, 2024-12, Vol.21 (1), p.98-6, Article 98 |
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| source | Publicly Available Content Database; PubMed Central |
| subjects | Adult AIDS treatment Alkynes Anti-HIV agents Anti-HIV Agents - adverse effects Anti-HIV Agents - therapeutic use Antiviral agents Benzoxazines - adverse effects Benzoxazines - therapeutic use Biological products industry Complications and side effects Cyclopropanes Dolutagravir-based antiretroviral therapy Dosage and administration Drug therapy Efavirenz Efavirenz-based antiretroviral therapy Female Heterocyclic Compounds, 3-Ring - adverse effects Heterocyclic Compounds, 3-Ring - therapeutic use Highly active antiretroviral therapy HIV (Viruses) HIV Infections - drug therapy HIV-1 - drug effects HIV-infected study participants Humans Lamivudine - therapeutic use Male Medical records Middle Aged Oxazines - therapeutic use Patient compliance Patient outcomes Pharmacology, Experimental Physiological aspects Piperazines - therapeutic use Pyridones - therapeutic use Retrospective evaluation Retrospective Studies Tanzania Tenofovir - therapeutic use Treatment Outcome Treatment outcomes Viral Load - drug effects |
| title | Brief communication: Long-term treatment outcomes of transitioning to dolutegravir-based ART from efavirenz in HIV study participants in Mbeya, Tanzania |
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