Abstract:
Introduction: The integrase inhibitor dolutegravir (DTG) has recently replaced the non nucleoside reverse transcriptase inhibitors (efavirenz and nevirapine) in several Sub-Saharan
African countries, including Tanzania. Since this change, there is scarce data on the current
treatment outcomes focusing on treatment-experienced HIV-infected patients switched to DTG
based regimens in Tanzania. Objectives: This study aimed to investigate immunological and
virological outcomes among treatment-experienced HIV-infected patients who were switched
to DTG based regimen in Tanzania. Results: We enrolled 397 patients, majority (65%) were
female patients with mean age of 42.7 (95% CI; 40.7 – 44.7) years. The mean baseline CD4+
cell count was 457.1 (95% CI; 426.6 – 489.8) cells/mm3 with 8.3% of patients with CD4+ cell
count <200 cells/mm3. The mean baseline viral load (VL) was 169.8 (95% CI; 128.8 – 223.9)
copies/ml, whereby 20.6% had VL ≥ 1000 copies/ml. After the use of a new fixed dose
combination of Tenofovir (TDF) 300 mg + Lamivudine (3TC) 300 mg + DTG 50 mg (TLD)
for at least 24 weeks, the overall rate of virological suppression (<50 copies/ml) was 89.9%
(95%CI 86.7% - 92.7%). The significant predictors of virological failure were overall duration
on ART use (p = 0.004), duration on TDF + 3TC, and Efavirenz (EFV) (TLE) (p = 0.007), and
baseline VL (p < 0.001). Conclusion: TLD regimen has provided favorable preliminary results
among patients who previously used TLE in HIV/AIDS treatment by showing good virological
and immunological outcomes. The long-term treatment outcomes require further investigation
