ArticleJournal of acquired immune deficiency syndromes (1999)2025
Initiation of Dolutegravir Versus Efavirenz on Viral Suppression and Retention at 6 months: A Regression Discontinuity Design.
Article in Journal of acquired immune deficiency syndromes (1999), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Effectiveness of ART optimization on viral load suppression in children and adolescents with HIV in Uganda: A quasi-experimental study.Medicine · 2026Article
- Initiation of dolutegravir vs. efavirenz on 12- and 24-month retention and viral suppression: a target trial emulation.Infectious diseases (London, England) · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundIn 2019, South Africa's Antiretroviral Therapy (ART) Treatment Guidelines replaced efavirenz with dolutegravir in first-line ART.
settingWe assessed the impact of this national guideline change on retention and viral suppression in the Themba Lethu Clinical Cohort, Johannesburg, South Africa. We applied a regression discontinuity design in a prospective cohort study of 1654 adults living with HIV initiating first-line ART within 12 months (±12 months) of the guideline change.
methodsWe compared outcomes in individuals presenting just before and after the guideline change and estimated intention-to-treat effects on initiating a dolutegravir- vs efavirenz-based regimen. Primary outcomes were retention and viral suppression. Participants were defined as retained in care if a visit took place within ±3 months of the 6-month end point. Viral suppression was defined as having a viral load ≤1000 copies/mL 3 months before and up to 6 months after the 6-month end point.
resultsThe 2019 guideline change led to an increase in uptake of dolutegravir. We noted a 26.6 percentage point increase in the proportion initiating dolutegravir [95% Confidence Interval (CI): 14.1 to 38.6]. We saw a small increase in viral suppression [Risk Difference (RD): 7.4 percentage points; 95% CI: -1.6 to 16.5] and no change in retention (RD: -1.7 percentage points; 95% CI: -13.9 to 10.5) at 6 months, though our findings were imprecise.
conclusionsOur estimates suggest early uptake of the revised treatment guidelines after implementation. Despite this, there was no meaningful change in viral suppression and retention rates at 6 months.
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