EACS2023: 346 Dolutegravir efficacy in achieving HIV viral load suppression after shifting from Non-nucleoside reverse transcriptase inhibitor based regimens: an Egyptian cross-sectional study M. Sherif , R. Mohamed , A. Hatem , L. Al Sehemy , M. Ismail Abdelraouf , A. M.Al-Sharif , N. El Garhy , R. Awad Awad , M. Salah Eldin Hamdy , G. Esmat , E. El Khateeb , A. M. Sayed , A. Cordie Cairo University, Cairo University Hospitals HIV Clinic, Endemic Medicine Department, Cairo, Egypt, Cairo University, Kasr Al-Aini HIV and Viral Hepatitis Fighting Group, Cairo University Hospitals, Cairo, Egypt, Cairo University, Clinical and Chemical Pathology, Cairo, Egypt, Cairo University, Endemic Medicine Department, Cairo, Egypt General data Abstract category: Antiretroviral therapy – observational studies Abstract body Purpose: Dolutegravir (DTG)-based regimens are recommended by The WHO and the National Egyptian guidelines as a first line antiretroviral therapy. A mass shifting to DTG-based regimens was applied in Egypt where HIV viral load (VL) testing isn’t widely available. This study aimed to test the ability of DTG in achieving VL suppression despite lack of baseline and pre-shift VL testing. Method: This cross-sectional study ran at Cairo University Hospitals HIV clinic between September 2022 and May 2023. People living with HIV (PLHIV) who shifted from Efavirenz to DTG-based regimen for ≥6 months with no reported baseline or preshifting VL tests were offered HIV VL, CD4 count and routine blood tests. Focused clinical interviews were performed including risk factors for HIV, co-infections, adherence to treatment, and DTG-related adverse events (AEs). Comparison was done between PLHIV who achieved and who failed to achieve VL suppression, using Chi-square, independent-T and Mann-Whitney tests. Results: The mean age of the 95 recruited PLHIV was 37±9 years, 80% were males. The median duration of HIV infection was 3.5 [2.5 – 6] years. The median duration of shift to DTG was 8 [6 – 12] months. Twenty six PLHIV reported DTG-related AEs, such as asthenia or myalgia that improved spontaneously. Seventy six PLHIV (80%) achieved VL suppression. PLHIV who achieved and who failed to achieve VL suppression had comparable demographic data, special habits and risk factors, treatment information, routine blood tests, CD4 counts, viral hepatitis co-infection, comorbidities, and DTG-related AEs. PLHIV with a detectable VL had significantly higher Alanine transferase (p-value 0.005). They received counselling regarding adherence to treatment and were scheduled to be tested after 3 months. Comparison between patients who achieved and those who failed to achieve VL suppression Data Total Failed Suppressed Pvalue No. = 95 No. = 19 No. = 76 DTG AEs Skin rash 1 (1.1%) 0 (0.0%) 1 (1.3%) 0.615 Bone/Joint/ Muscle pain 7 (7.4%) 1 (5.3%) 6 (7.9%) 0.695 Asthenia 8 (8.4%) 0 (0.0%) 8 (10.5%) 0.139 Headache 1 (1.1%) 0 (0.0%) 1 (1.3%) 0.615 Dizziness 1 (1.1%) 0 (0.0%) 1 (1.3%) 0.615 Sleep disturbance 5 (5.3%) 1 (5.3%) 4 (5.3%) 1.000 Anxiety 1 (1.1%) 0 (0.0%) 1 (1.3%) 0.615 Neurosychiatric disorders 2 (2.1%) 1 (5.3%) 1 (1.3%) 0.284 Co-infections HCV 15 (15.8%) 3 (15.8%) 12 (15.8%) 1.000 HBV 3 (3.2%) 0 (0.0%) 3 (3.9%) 0.379 TB 1 (1.1%) 1 (5.3%) 0 (0.0%) 0.044 STI 10 (10.5%) 2 (10.5%) 8 (10.5%) 1.000 Labs CD4 count at inclusion: <200 200-500 >500 7 (7.4%) 3 (15.8%) 4 (5.3%) 0.288 37 (38.9%) 7 (36.8%) 30 (39.5%) 51 (53.7%) 9 (47.4%) 42 (55.3%) AST (IU/L) Mean±SD Range 25.3 ± 8.6 12 - 70 28.8 ± 12.1 15 - 70 24.48 ± 7.41 12 - 65 0.052 ALT (IU/L) Mean±SD Range 24.4 ± 11.3 12 - 94 30.9 ± 20.4 14 - 94 22.87 ± 6.76 12 - 51 0.005 BMI categories Underweight Normal Overweight Obese 4 (4.2%) 1 (5.3%) 3 (3.9%) 0.405 39 (41.1%) 5 (26.3%) 34 (44.7%) 31 (32.6%) 9 (47.4%) 22 (28.9%) 21 (22.1%) 4 (21.1%) 17 (22.4%) Conclusions: Shifting to DTG-based regimens is effective in achieving VL suppression despite lack of baseline and pre-shift testing. Improving access to VL might improve adherence to treatment and VL suppression. General conditions 1. I confirm that I previewed this abstract and that all information is correct. I accept that the content of this abstract cannot be modified or corrected after the submission deadline and I am aware that it will be published exactly as submitted.: Yes 2. I confirm that the submission of the abstract constitutes my consent to publication (e.g. conference website, programmes, other promotions, etc.). : Yes 3. I herewith confirm that the contact details saved in this system are those of the corresponding author, who will be notified about the status of the abstract. The corresponding author is responsible for informing the other authors about the status of the abstract.: Yes 4. I agree that all data provided may be used (saved, stored, processed, transmitted and deleted) in compliance with the privacy policy to provide the services described.: Yes 1 1,2 1 1 1 1 1 1 3 4 3 3,2 1,2 1 2 3 4 105
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