Adherence, resistance, and viral suppression on dolutegravir in sub-Saharan Africa: implications for the TLD era.
Adherence, resistance, and viral suppression on dolutegravir in sub-Saharan Africa: implications for the TLD era.
复制标题
在撒哈拉以南非洲的多卢特格拉维（Dolutegravir）的遵守，抵抗和病毒抑制：对TLD时代的影响。
DOI：
10.1097/qad.0000000000003082
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发表时间：
2021-12-15
期刊：
影响因子：
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通讯作者：
Siedner MJ
中科院分区：
文献类型：
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作者：
McCluskey SM;Pepperrell T;Hill A;Venter WDF;Gupta RK;Siedner MJ
多洛替格列韦(DTG)现在是全球首选的一线抗逆转录病毒疗法(ART)的组成部分。Advance和NAMSAL是两项具有里程碑意义的临床试验，专门在撒哈拉以南非洲地区进行，研究基于DTG的一线方案对天真的ART患者的有效性。在这篇综述中，我们检查了这些研究的数据，以考虑依从性和HIV耐药性对基于DTG的ART治疗失败的贡献，与基于efavirenz的ART相比，后者具有较低的耐药性遗传屏障。我们还讨论了病毒学失败对DTG的影响，并合并了当前可用的数据，以结束对基于DTG的ART的病毒学监测的建议。
Dolutegravir (DTG) is now a component of preferred first-line antiretroviral therapy (ART) worldwide. ADVANCE and NAMSAL were two landmark clinical trials conducted exclusively in sub-Saharan Africa which studied the effectiveness of DTG-based first-line regimens for ART-naïve individuals. In this review, we examine the data from these studies to consider the contributions of adherence and HIV drug resistance to treatment failure on DTG-based ART, as compared to efavirenz-based ART which has a lower genetic barrier to resistance. We also discuss the implications of virologic failure on DTG and consolidate currently available data to conclude with recommendations for virologic monitoring on DTG-based ART.