Background:
The efficacy and safety of efavirenz-based regimen (EFV) was reviewed and has called for concern. Dolutegravir-based regimen (DTG) which has shown a better efficacy on viral suppression than EFV was launched in April 2020 at national level. The present study aimed at evaluating the impact of DTG on viral suppression when compared to EFV among patients on antiretroviral therapy in the Littoral and South regions of Cameroon.
Methods:
It was a retrospective data analysis involving 72 health facilities of the Littoral and South regions. We considered for this analysis, patients who were initially on EFV with a documented viral load result, were transitioned to DTG, maintained for at least 12 months and had a follow-up viral load test done. Viral suppression was defined as viral load less than 1000 copies per ml. We compared viral suppression rates before and after transition to TLD. We used the two-proportion z-test to compare suppression rates in both groups.
Results:
At baseline, 12935 patients were on EFV with a viral suppression of 88% all transitioned to DTG and had a viral suppression after transition of 95%. This reduction in viral load was very significant p<0.000. We did a subanalysis of 506 unsuppressed patients on EFV and out of them 399 (79%) had suppressed after transition to DTG.
Conclusion: Transitioning patients from EFV to DTG significantly improved viral suppression and evidenced that, dolutegravir had a better efficacy and superior to Efavirenz.
Keywords: Transition, Dolutegravir, Suppression.