Evidence map›Paper›PMID 40980568›Full record

ArticleOpen forum infectious diseases2025

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.

Jennifer Anne Brown, Lara Lewis, Yukteshwar Sookrajh, Lungile Hobe, Thulani Ngwenya, Johan van der Molen, Kwabena Asare, Kwena Tlhaku, Mlungisi Khanyile, Thokozani Khubone and 3 more

Abstract read
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In one paragraph

Article in Open forum infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Jennifer Anne BrownCentre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.ORCID https://orcid.org/0000-0003-1874-6153
Lara LewisCentre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.ORCID https://orcid.org/0000-0001-5373-2086
Yukteshwar SookrajheThekwini Municipality Health Unit, eThekwini Municipality, Durban, South Africa.ORCID https://orcid.org/0000-0001-9029-5153
Lungile HobeMseleni Hospital, uMkhanyakude District, Nhlamvu, KwaZulu-Natal, South Africa.
Thulani NgwenyaBethesda Hospital, uMkhanyakude District, uBombo, KwaZulu-Natal, South Africa.
Johan van der MolenCentre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.
Kwabena AsareCentre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.ORCID https://orcid.org/0000-0002-5074-2315
Kwena TlhakuCentre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.ORCID https://orcid.org/0000-0002-2105-9146
Mlungisi KhanyileCentre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.
Thokozani KhuboneeThekwini Municipality Health Unit, eThekwini Municipality, Durban, South Africa.
Christian BottomleyDepartment of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.ORCID https://orcid.org/0000-0002-5241-8412
Nigel GarrettCentre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.ORCID https://orcid.org/0000-0002-4530-234X
Jienchi DorwardCentre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.ORCID https://orcid.org/0000-0001-6072-1430

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Aligning with the World Health Organization, South Africa has replaced ritonavir-boosted lopinavir (LPV/r) with dolutegravir (DTG) in second-line antiretroviral therapy (ART) after treatment failure with tenofovir disoproxil fumarate (TDF)/lamivudine or emtricitabine (XTC)/efavirenz (EFV). Initial guidance included special considerations for DTG use among women. Methods: We analyzed routine deidentified data of adults switched from TDF/XTC/EFV to second-line AZT/XTC/LPV/r, AZT/XTC/DTG, or TDF/XTC/DTG between December 2019 and December 2023 at 108 healthcare facilities in KwaZulu-Natal, South Africa. Among people switched before July 2021, we emulated a target trial comparing 24-month death or loss to follow-up (LTFU), and viremia (>50 copies/mL). We conducted intention-to-treat and per-protocol analyses using weighted logistic regression with bootstrapped CIs. Results: Overall, women were less likely than men to switch to DTG (RR: 0.92 [95% CI: .88, .96]; Conclusions: While retention was similar across regimens, viremia was less common on DTG-based ART, supporting current guidelines.

Indexed as

antiretroviral therapydolutegravirretention in careritonavir-boosted lopinavirviral load

Identifiers

PMID40980568
PMCPMC12448401

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.