Browsing by Author "Taing, N. Aung"

Now showing 1 - 1 of 1
  • Thumbnail Image
    Item
    Population Effectiveness of Dolutegravir Implementation in Uganda: A Prospective Observational Cohort Study (DISCO), 48-Week Results
    (The Journal of Infectious Diseases, 2024) Suzanne, M. McCluskey; Muyindike, Winnie R.; Nanfuka, Victoria; Omoding, Daniel; Nimusiima, Komukama; Barigye, Ian T.; Kansiime, Lydia; Tumusiime, Justus; Taing, N. Aung; Ashley, Stuckwisch; Bethany, Hedt-Gauthier; Vincent, C. Marconi; Mahomed-Yunus, S. Moosa; Deenan, Pillay; Jennifer, Giandhari; Richard, Lessells; Ravindra, K. Gupta; Mark, J. Siedner
    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. 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.