Restoring well-being: quality of life improvements following dolutegravir-based therapy after antiretroviral failure.

BACKGROUND

Dolutegravir-based antiretroviral therapy has improved virologic outcomes in people living with HIV; however, its effects on Health-Related Quality of Life (HRQoL), particularly among individuals with prior antiretroviral failure, remain insufficiently characterized. We aimed to compare HRQoL in people living with HIV initiating dolutegravir-based regimens, with or without previous antiretroviral failure.

METHODS

This multicenter study was conducted across 15 Brazilian HIV centers. Participants completed the RAND-36 questionnaire at baseline and after 12-months of dolutegravir-based therapy. HRQoL changes were assessed within groups and compared between groups using change scores over time.

RESULTS

A total of 439 participants were included in the longitudinal analysis, of whom 373 had no prior therapeutic failure and 66 had previous antiretroviral failure. Among participants with prior failure, significant improvements were observed in role-emotional functioning (Δ = 17.17; p = 0.010), social functioning (Δ = 10.79; p = 0.008), and pain (Δ = 10.66; p = 0.024), whereas HRQoL remained stable among individuals switching therapy without prior failure. Between-group comparisons demonstrated significantly greater improvements in role-emotional functioning, social functioning, pain, and general health among individuals with prior therapeutic failure.

CONCLUSIONS

Switching to dolutegravir-based therapy was associated with stable HRQoL among individuals on suppressive regimens and with significant improvements among those with prior antiretroviral failure. These findings support the relevance of psychosocial and patient-reported outcomes in the evaluation of treatment response in people living with HIV.