ArticleSAGE open medicine2025
Role of Dolutegravir-based antiretroviral treatment in achieving an undetectable HIV-1 viral load among women attending prevention of mother-to-child transmission clinics in Addis Ababa, Ethiopia.
Article in SAGE open medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: This study aimed to determine the prevalence of detectable HIV-1 viral load and associated factors among pregnant and lactating women on Dolutegravir-based and non-Dolutegravir-based regimens. Methods: HIV-positive pregnant and breastfeeding women enrolled in a cross-sectional study design incorporating Dolutegravir versus non-Dolutegravir group for comparison purposes, and the study was conducted from September 2022 to March 2023. In total, 684 women receiving antiretroviral treatment (456 on Dolutegravir-based and 228 on non-Dolutegravir-based regimens) were enrolled across 16 prevention of mother-to-child transmission clinics. An undetectable viral load was defined as <20 RNA copies/mL. Univariable and multivariable regression models were used to determine the associations of the detectable viral load with factors such as sociodemographic, clinical, obstetric, and laboratory parameters. Results: The prevalence of detectable viral load on a non-Dolutegravir-based regimen was 32.9% and on a Dolutegravir-based regimen group was 19.7%. The overall prevalence was 24.1% (95% CI: 20.9-27.6). Compared with non-Dolutegravir-based regimens, Dolutegravir-based regimens were associated with 69% (AOR: 0.31; 95% CI: 0.16-0.61) lower risk of having a detectable viral load. The median viral load was significantly lower in women on a Dolutegravir-based regimen (1.66 log copies/mL) compared to those on a non-Dolutegravir-based regimen (2.11 log copies/mL; Conclusion: Despite the scale-up of Dolutegravir-based regimens, the overall prevalence of detectable viremia was 24.1%, with a higher prevalence of 32.9% among women on non-Dolutegravir-based regimens indicating a programmatic challenge that could affect mother-to-child transmission outcomes. Strengthening adherence monitoring and maintaining World Health Organization clinical stage I is crucial for achieving undetectable viral load levels in pregnant and breastfeeding women.
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