Transition to dolutegravir-based ART in 35 low-and middle-income countries: A global survey of HIV care clinics
Issued Date
2024-01-01
Resource Type
ISSN
02699370
eISSN
14735571
Scopus ID
2-s2.0-85203514366
Pubmed ID
39236112
Journal Title
AIDS
Rights Holder(s)
SCOPUS
Bibliographic Citation
AIDS (2024)
Suggested Citation
Zaniewski E., Skrivankova V.W., Brazier E., Avihingsanon A., Cardoso S.W., Cesar C., Chenal H., Crabtree-Ramírez B.E., Ditangco R.A., Ebasone P.V., Eley B., Euvrard J.G., Fatti G., Huwa J.M., Lelo P., Machado D.M., Messou E.K., Minga A.K., Muleebwa J., Mundhe S., Murenzi G., Muyindike W.R., Nsonde D.M., Obatsa S.M., Odhiambo J., Prozesky H.W., Rungmaitree S., Semeere A.S., Seydi M., Sipambo N., Sudjaritruk T., Technau K.G., Tiendrebeogo T., Twizere C., Ballif M. Transition to dolutegravir-based ART in 35 low-and middle-income countries: A global survey of HIV care clinics. AIDS (2024). doi:10.1097/QAD.0000000000004007 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/101221
Title
Transition to dolutegravir-based ART in 35 low-and middle-income countries: A global survey of HIV care clinics
Author(s)
Zaniewski E.
Skrivankova V.W.
Brazier E.
Avihingsanon A.
Cardoso S.W.
Cesar C.
Chenal H.
Crabtree-Ramírez B.E.
Ditangco R.A.
Ebasone P.V.
Eley B.
Euvrard J.G.
Fatti G.
Huwa J.M.
Lelo P.
Machado D.M.
Messou E.K.
Minga A.K.
Muleebwa J.
Mundhe S.
Murenzi G.
Muyindike W.R.
Nsonde D.M.
Obatsa S.M.
Odhiambo J.
Prozesky H.W.
Rungmaitree S.
Semeere A.S.
Seydi M.
Sipambo N.
Sudjaritruk T.
Technau K.G.
Tiendrebeogo T.
Twizere C.
Ballif M.
Skrivankova V.W.
Brazier E.
Avihingsanon A.
Cardoso S.W.
Cesar C.
Chenal H.
Crabtree-Ramírez B.E.
Ditangco R.A.
Ebasone P.V.
Eley B.
Euvrard J.G.
Fatti G.
Huwa J.M.
Lelo P.
Machado D.M.
Messou E.K.
Minga A.K.
Muleebwa J.
Mundhe S.
Murenzi G.
Muyindike W.R.
Nsonde D.M.
Obatsa S.M.
Odhiambo J.
Prozesky H.W.
Rungmaitree S.
Semeere A.S.
Seydi M.
Sipambo N.
Sudjaritruk T.
Technau K.G.
Tiendrebeogo T.
Twizere C.
Ballif M.
Author's Affiliation
Siriraj Hospital
Lighthouse Trust
Bordeaux Population Health Research Center (BPH)
Institute of Social and Preventive Medicine
Mbarara University of Science and Technology
Makerere University
Research Institute for Tropical Medicine
Kenya Medical Research Institute
Fundacion Huesped
Chris Hani Baragwanath Hospital
Instituto Nacional de Infectologia Evandro Chagas (INI)
Universidade Federal de São Paulo
Red Cross War Memorial Children's Hospital
University Hospital Bern
Tygerberg Hospital
Instituto Nacional de la Nutrición Salvador Zubiran
The City University of New York
Rahima Moosa Mother and Child Hospital
Faculty of Medicine, Chulalongkorn University
Stellenbosch University, Faculty of Medicine and Health Sciences
Stellenbosch University
Chiang Mai University
University of Cape Town
USAID Dumisha Afya-Busia County
Research for Development
Centre National de Reference en Matière de VIH/SIDA
Kalisizo Hospital
Clinical Research Education Networking and Consultancy
ACONDA-CePReF
Programme PAC-CI
BJ Government Medical College
Fann University Hospital
Kheth'Impilo AIDS Free Living
Mbarara Regional Referral Hospital
Centre de Traitement Ambulatoire de Brazzaville
Pediatric Hospital Kalembe Lembe
Centre Intégré de Recherches Biocliniques d'Abidjan (CIRBA)
Lighthouse Trust
Bordeaux Population Health Research Center (BPH)
Institute of Social and Preventive Medicine
Mbarara University of Science and Technology
Makerere University
Research Institute for Tropical Medicine
Kenya Medical Research Institute
Fundacion Huesped
Chris Hani Baragwanath Hospital
Instituto Nacional de Infectologia Evandro Chagas (INI)
Universidade Federal de São Paulo
Red Cross War Memorial Children's Hospital
University Hospital Bern
Tygerberg Hospital
Instituto Nacional de la Nutrición Salvador Zubiran
The City University of New York
Rahima Moosa Mother and Child Hospital
Faculty of Medicine, Chulalongkorn University
Stellenbosch University, Faculty of Medicine and Health Sciences
Stellenbosch University
Chiang Mai University
University of Cape Town
USAID Dumisha Afya-Busia County
Research for Development
Centre National de Reference en Matière de VIH/SIDA
Kalisizo Hospital
Clinical Research Education Networking and Consultancy
ACONDA-CePReF
Programme PAC-CI
BJ Government Medical College
Fann University Hospital
Kheth'Impilo AIDS Free Living
Mbarara Regional Referral Hospital
Centre de Traitement Ambulatoire de Brazzaville
Pediatric Hospital Kalembe Lembe
Centre Intégré de Recherches Biocliniques d'Abidjan (CIRBA)
Corresponding Author(s)
Other Contributor(s)
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.