Evaluation of treatment outcomes in patients receiving Dolutegravir- containing first -line anti-retroviral therapy at the Katutura Intermediate Hospital in Namibia
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Date
2024
Authors
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Publisher
University of Namibia
Abstract
There is currently insufficient information regarding the safety and effectiveness of
Dolutegravir (DTG)-based ART regimen in Namibia. This study was conducted to
evaluate the treatment outcomes of dolutegravir containing first line antiretroviral
therapy (ART).
Methods: This was a retrospective quantitative study that included ART-naïve adults
who initiated dolutegravir containing first-line ART from January 2020 to March 2021
at the Intermediate Hospital Katutura (IHK) in Namibia.
Results: 120 patients were included in the study. Most (n=89, 74%) experienced
weight gain, and 15 experienced treatment failure. At the end of 18 months, 75% of
the cohort remained virally suppressed. The prevalence of treatment failure was found
to be 12.5% with the prevalence rate of treatment failure of 8.3 cases per 100 patient
years. But considering the switching as confirmation of virological failure, the
prevalence rate was 2.2 cases per 100 patient years. Active tuberculosis (TB) was
found to be statistically associated with treatment failure with a P value ˂ 0.001.
PLWH co-infected with TB on TLD were 18 times more likely to have treatment
failure (OR=18.1,95% CI: 4.65,70.45). Only 3.3% (n = 4) had their DTG-based ART
regimen changed or switched due to treatment failure. The only reported adverse effect
observed in the study was weight gain. The proportion of patients who experienced
clinically significant weight gain (defined as weight gain ˃ 3kg) after 18 months of
ART initiated was 20.2%. The prevalence rate for clinically significant weight gain
was 13.5 cases per 100 patient years. The mean weight gain was found to be 4 kg (SD
59.45 ± 16.89). There was statistical significance between weight gain and gender with
a p-value =0.026 with females being four times more likely to have gained weight
(OR=3.9,95% CI: 1.3,12.4).
Conclusion: DTG-containing regimens effectively achieved viral suppression among
treatment-naive HIV patients, with weight gain reported as the only adverse effect.
More research with a larger patient sample across multiple centres is needed to explore
the long-term treatment outcomes of DTG
Description
A thesis submitted in fulfillment of the requirements for the Degree of Master of Pharmacy in Clinical Pharmacy
Keywords
Dolutegravir- containing first -line anti-retroviral therapy, University of Namibia, Katutura Intermediate Hospital, Namibia, Evaluation of treatment, Dolutegravir, Tenofovir/Lamivudine/Dolutegravir, TB, Antiretroviral therapy, Adverse drug effect, Treatment failure