ArticleSouthern African journal of HIV medicine2025
Viral suppression in adults on efavirenz- or dolutegravir-based antiretroviral therapy in Mopani District, South Africa.
Article in Southern African journal of HIV 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
Background: Dolutegravir- has superior viral suppression compared to efavirenz-based antiretroviral therapy (ART). However, there are limited programmatic data on suppression in rural areas of South Africa. Objectives: We aimed to compare 6- and 12-month viral suppression of dolutegravir and efavirenz regimens and determine factors available in TIER.Net (the national electronic database for HIV and tuberculosis care) associated with suppression. Method: We conducted a retrospective cohort study using Mopani District programme data from TIER.Net. Clients aged ≥ 15 years initiated on tenofovir-lamivudine-dolutegravir (TLD) or tenofovir-emtricitabine-efavirenz (TEE) between 01 October 2021 and 31 March 2023, with ≥ 150 days in care, were included. We analysed 6- and 12-month suppression proportions and factors associated with suppression using logistic regression. Results: A total of 472 clients on TEE and 944 on TLD were included. Six-month viral loads were available for 47.7% (225/472) of TEE and 57.4% (542/944) of TLD clients. Six-month suppression (< 50 copies/mL) was 65.5% (355/542) for TLD and 53.8% (121/225) for TEE ( Conclusion: TLD showed improved suppression compared to TEE at 6 but not 12 months. The high proportion of clients with low-level viraemia is concerning. All clients, regardless of regimen, need evaluation for adherence support.
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