ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024
Emergence of Acquired Dolutegravir Resistance in Treatment-experienced People With HIV in Lesotho.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Deep sequencing reveals underestimated burden of integrase inhibitor resistance mutations in people living with HIV: a global individual patient data meta-analysis.Emerging microbes & infections · 2025Pooled it
- HIV drug resistance amongst children and adolescents with viraemia in Lesotho and Tanzania: a nested analysis in the GIVE MOVE trial.The Journal of antimicrobial chemotherapy · 2026Trial
- Trial
- Unequal patterns of tuberculosis in women of reproductive age: Insights from the Global burden of disease study 2021.Infectious medicine · 2026Article
- Review
- Tolerability of lopinavir versus dolutegravir in children and adolescents with HIV.AIDS (London, England) · 2026Article
- Novel integrase mutations linked to genotypic DTG resistance in African non-B HIV-1 strains: the DTG RESIST study.The Journal of antimicrobial chemotherapy · 2026Article
- Approaches to the Management of Virologic Failure on Dolutegravir-Based Antiretroviral Therapy in the 50 Countries With the Highest Adult HIV Prevalence.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Maintain, not obtain: rethinking HIV care in sub-Saharan Africa in the era of dolutegravir.Frontiers in public health · 2026Article
- HIV-1 Resistance to Dolutegravir in Benin: The Need to Improve and Strengthen Therapeutic Patient Education Strategies to Achieve the Third Objective 95 of UNAIDS 95-95-95 Target.Case reports in infectious diseases · 2026Article
- Factors Associated With Incomplete Adherence to Dolutegravir-Based Antiretroviral Therapy in Southwestern Uganda.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Dolutegravir Resistance in Mozambique: Insights from a Programmatic HIV Resistance Testing Intervention in a Highly Antiretroviral Therapy-Experienced Cohort.Infectious disease reports · 2025Article
- Uptake and 24-month Outcomes of Dolutegravir- Versus Lopinavir-based Second-line Antiretroviral Therapy for People With HIV in South Africa: A Retrospective Cohort Study and Emulated Target Trial.Open forum infectious diseases · 2025Article
- Predictors of treatment-emergent resistance to dolutegravir.The lancet. HIV · 2025Review
- Virology Outcomes of Tenofovir-lamivudine-dolutegravir in Treatment-naïve and Virologically Suppressed Individuals Switching From an NNRTI-based Regimen: An Observational Analysis at 13 Sites.Open forum infectious diseases · 2025Article
- Resistance to Dolutegravir in Treatment-experienced Patients in South Africa: A Retrospective Cohort Study.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- High prevalence of reverse transcriptase inhibitors associated resistance mutations among people living with HIV on dolutegravir-based antiretroviral therapy in Francistown, Botswana.The Journal of antimicrobial chemotherapy · 2025Article
- Article
- Virologic Failure and Drug Resistance After Programmatic Switching to Dolutegravir-based First-line Antiretroviral Therapy in Malawi and Zambia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Observational
- HIV Drug Resistance Profile in Clients Experiencing Treatment Failure After the Transition to a Dolutegravir-Based First-Line Antiretroviral Treatment Regimen in Mozambique.Pathogens (Basel, Switzerland) · 2025Article
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundSince 2019, the World Health Organization has recommended dolutegravir-based antiretroviral therapy (ART) as the preferred regimen for human immunodeficiency virus management. Large-scale programmatic transitioning to dolutegravir-based ART was subsequently implemented across Africa, often in the absence of recent viral load testing and without access to genotypic resistance testing (GRT) in case of viremia.
methodsThis study assessed emerging dolutegravir resistance in the routine care of the Viral Load Cohort North-East Lesotho. We included pediatric and adult participants who changed from nonnucleoside reverse transcriptase inhibitor- to dolutegravir-based ART and had at least 1 viral load assessment before and after the change. We sequenced available samples of participants fulfilling the additional virological criteria of having 2 viremic episodes while taking dolutegravir, with at least 1 viral load ≥500 copies/mL taken ≥18 months after changing to dolutegravir.
resultsAmong 15 349 participants, 157 (1.0%) met the virological criteria, and GRT was successful for 85 (0.6%). Among these 85, 8 (9.4%) had dolutegravir resistance, with 2 (2.4%) and 6 (7.1%) predicted to have intermediate- and high-level dolutegravir resistance, respectively. One participant had 2, 2 had 1, and 5 had 0 active drugs in their regimen. A GRT from before the change to dolutegravir was available for 5 of these 8 participants: 4 had 0 and 1 had 1 active drug in their nonnucleoside transcriptase inhibitor-based regimen.
conclusionsNine percent of people with persistent or recurring human immunodeficiency virus viremia ≥18 months after changing to dolutegravir-based ART had dolutegravir resistance. Detection and management of emerging dolutegravir resistance must be addressed across Africa.
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