ArticleCureus2026
Longitudinal Hepatic and Metabolic Trajectories Following Dolutegravir Initiation in Antiretroviral Therapy (ART)-Naïve People Living With HIV: A Prospective Cohort Study From South India.
Article in Cureus, 2026. 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 (DTG)-based combination antiretroviral therapy (cART), specifically the tenofovir disoproxil fumarate, lamivudine, and dolutegravir (TLD) regimen, is being widely prescribed for the management of people living with HIV (PLHIV) in India and other low- and middle-income countries. Although DTG is well-tolerated, concerns persist regarding its hepatic and metabolic safety. Prospective real-world data characterizing the longitudinal hepatic and metabolic trajectories following DTG initiation in antiretroviral therapy (ART)-naïve South Asian PLHIV remain limited. Therefore, we conducted a prospective study to determine the incidence and grading of liver enzyme elevation (LEE) and characterize the longitudinal trajectories of alanine aminotransferase (ALT), anthropometric, and glycemic parameters over six months in ART-naïve PLHIV initiated on the TLD regimen. Methodology We conducted a six-month prospective cohort study and followed 101 ART-naïve adult PLHIV initiated on the TLD regimen at a tertiary care hospital in Bengaluru, India. Serum ALT, weight, body mass index (BMI), waist circumference, and random blood sugar (RBS) were measured at baseline and at one, two, three, and six months. Repeated-measures analysis of variance (rmANOVA) was used to assess longitudinal trends; paired-samples t-test compared baseline and six-month values for waist circumference; chi-square tests examined categorical associations. Results All 101 enrolled participants completed the six-month follow-up. The mean age was 36.5 ± 11.2 years, and 67 (66.3%) participants were male. Any-grade LEE occurred in 22 (21.8%) participants. Mean ALT rose transiently from 26 ± 14 IU/L at baseline to a peak of 32 IU/L at one month, then declined progressively to 27 ± 17 IU/L at six months; the overall trajectory was not statistically significant (
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