Open forum infectious diseases · 2025
Three-Year Outcomes After Programmatic Transitioning to Dolutegravir in the Context of Severe Civil Unrest in Haiti.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Liautaud Bernard, Chico Ana Sanchez, Macius Youry, Abuhay Sosina, Joseph Patrice, Reeder Harrison T, Bolas Theo, Marcelin Adias, Moïse Colette Guiteau, Apollon Alexandra, Cremieux Pierre, Pape Jean W, Koenig Serena P
Аннотация
BACKGROUND: Tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD) is widely prescribed in low and middle-income countries. Data on long-term outcomes are limited.
METHODS: We included all persons with HIV (PWH) ≥15 years of age who initiated or switched to TLD in Port-au-Prince, Haiti. We described treatment outcomes by pre-switch viral load and assessed predictors of virologic failure using multivariable logistic regression.
RESULTS: A total of 10 354 PWH initiated or switched to TLD from November 2018 to March 2021, and were included in the analyses. Of these, 2217 (21.4%) were ART-naïve and 8137 (78.6%) switched from an non-nucleoside reverse transcriptase inhibitor (NNTRI)-based regimen. Median follow-up time on TLD was 2.8 years (IQR: 2.3, 3.1). HIV-1 RNA <1000 copies/mL was achieved at the latest measurement in 92.7% of recipients of care (RoC) with pre-switch suppression, 88.5% without pre-switch viral load, 58.3% with pre-switch failure, and 81.8% of RoC ART-naïve at TLD initiation. Among treatment-experienced RoC, predictors of ≥1000 copies/mL at latest test included younger age (adjusted odds ratio [aOR]: 0.44; 95% CI: 0.34, 0.57 for age ≥50 vs <30 years), shorter time on ART (aOR: 0.91; 95% CI: 0.89, 0.93/year), lower education (aOR: 1.31; 95% CI: 1.13, 1.52), and higher pre-switch viral load: (aOR: 7.23; 95% CI: 6.06, 8.63 for ≥10 000 vs < 1000 copies/mL).
CONCLUSIONS: Virologic outcomes on TLD are outstanding for PWH with pre-switch suppression. However, rates of virologic suppression are suboptimal among PWH who were ART-naïve at TLD initiation, and among those with a history of pre-switch failure, additional interventions are necessary, including access to long-acting treatment regimens.
METHODS: We included all persons with HIV (PWH) ≥15 years of age who initiated or switched to TLD in Port-au-Prince, Haiti. We described treatment outcomes by pre-switch viral load and assessed predictors of virologic failure using multivariable logistic regression.
RESULTS: A total of 10 354 PWH initiated or switched to TLD from November 2018 to March 2021, and were included in the analyses. Of these, 2217 (21.4%) were ART-naïve and 8137 (78.6%) switched from an non-nucleoside reverse transcriptase inhibitor (NNTRI)-based regimen. Median follow-up time on TLD was 2.8 years (IQR: 2.3, 3.1). HIV-1 RNA <1000 copies/mL was achieved at the latest measurement in 92.7% of recipients of care (RoC) with pre-switch suppression, 88.5% without pre-switch viral load, 58.3% with pre-switch failure, and 81.8% of RoC ART-naïve at TLD initiation. Among treatment-experienced RoC, predictors of ≥1000 copies/mL at latest test included younger age (adjusted odds ratio [aOR]: 0.44; 95% CI: 0.34, 0.57 for age ≥50 vs <30 years), shorter time on ART (aOR: 0.91; 95% CI: 0.89, 0.93/year), lower education (aOR: 1.31; 95% CI: 1.13, 1.52), and higher pre-switch viral load: (aOR: 7.23; 95% CI: 6.06, 8.63 for ≥10 000 vs < 1000 copies/mL).
CONCLUSIONS: Virologic outcomes on TLD are outstanding for PWH with pre-switch suppression. However, rates of virologic suppression are suboptimal among PWH who were ART-naïve at TLD initiation, and among those with a history of pre-switch failure, additional interventions are necessary, including access to long-acting treatment regimens.