Transition to Pediatric Dolutegravir: A Before and After Study of Virologic Suppression Rate Among Pediatric Treatment Cohort in Rivers State, Nigeria
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Abstract
Background: Dolutegravir (DTG) is known for its high genetic resistance barrier and reduced occurrence of adverse drug reactions. It has demonstrated superiority over protease inhibitor-based regimens, showing a lower risk of treatment failure in infants and young children compared to lopinavir/ritonavir (LPV/r) formulations. This study compared the rates of viral suppression in children living with HIV (CLHIV) weighing less than 20kg who transitioned from Lopinavir-Ritonavir (LPV/r) regimen to peadiatric dolutegravir (pDTG)-based regimen.
Methods: A descriptive study conducted in Rivers State to compare the virologic suppression among CLHIV on LPV/r and pDTG treatment. Descriptive statistics using counts and proportions for categorical variables and means and standard deviations for continuous variables. Test of association using McNamar Chi-square. P-value 0.05.
Results: The mean age before and after the transition to pDTG was 4 years and 5 years, respectively. Before the transition to pDTG, 88.2% (656) of children were virally suppressed. After the cohort was transitioned to pDTG, viral suppression increased to 90.2% (671). The disaggregated percentage of viral load suppression after transition to pDTG showed that the undetectable viral load among the suppressed cohort was 99.7%. However, before transition to pDTG, it was 84%; these proportions were also not statistically significant (p-value = 0.167)
Conclusion: The introduction of dolutegravir-based anti-retroviral therapy in the peadiatric cohort of the study improved viral load suppression by 2% but this was not statistically significant. Further studies may be necessary to explore other essential factors that may be operational in achieving viral suppression in CLHIV.
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