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High acceptability and viral suppression rate for first-Line patients on a dolutegravir-based regimen: An early adopter study in Nigeria

Nigeria adopted dolutegravir (DTG) as part of first line (1L) antiretroviral therapy (ART) in 2017. However, there is limited documented experience using DTG in sub-Saharan Africa. Our study assessed DTG acceptability from the patient’s perspective as well as treatment outcomes at 3 high-volume faci...

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Autores principales: Abudiore, Opeyemi, Amamilo, Ikechukwu, Campbell, Jennifer, Eigege, Williams, Harwell, Joseph, Conroy, James, Jiboye, Justus, Lufadeju, Folu, Amole, Carolyn, Wiwa, Owens, Anweh, Damien, Agbaji, Oche Ochai, Akanmu, Alani Sulaimon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191360/
https://www.ncbi.nlm.nih.gov/pubmed/37196012
http://dx.doi.org/10.1371/journal.pone.0284767
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author Abudiore, Opeyemi
Amamilo, Ikechukwu
Campbell, Jennifer
Eigege, Williams
Harwell, Joseph
Conroy, James
Jiboye, Justus
Lufadeju, Folu
Amole, Carolyn
Wiwa, Owens
Anweh, Damien
Agbaji, Oche Ochai
Akanmu, Alani Sulaimon
author_facet Abudiore, Opeyemi
Amamilo, Ikechukwu
Campbell, Jennifer
Eigege, Williams
Harwell, Joseph
Conroy, James
Jiboye, Justus
Lufadeju, Folu
Amole, Carolyn
Wiwa, Owens
Anweh, Damien
Agbaji, Oche Ochai
Akanmu, Alani Sulaimon
author_sort Abudiore, Opeyemi
collection PubMed
description Nigeria adopted dolutegravir (DTG) as part of first line (1L) antiretroviral therapy (ART) in 2017. However, there is limited documented experience using DTG in sub-Saharan Africa. Our study assessed DTG acceptability from the patient’s perspective as well as treatment outcomes at 3 high-volume facilities in Nigeria. This is a mixed method prospective cohort study with 12 months of follow-up between July 2017 and January 2019. Patients who had intolerance or contraindications to non-nucleoside reverse-transcriptase inhibitors were included. Patient acceptability was assessed through one-on-one interviews at 2, 6, and 12 months following DTG initiation. ART-experienced participants were asked about side effects and regimen preference compared to their previous regimen. Viral load (VL) and CD4+ cell count tests were assessed according to the national schedule. Data were analysed in MS Excel and SAS 9.4. A total of 271 participants were enrolled on the study, the median age of participants was 45 years, 62% were female. 229 (206 ART-experienced, 23 ART-naive) of enrolled participants were interviewed at 12 months. 99.5% of ART-experienced study participants preferred DTG to their previous regimen. 32% of particpants reported at least one side effect. “Increase in appetite” was most frequently reported (15%), followed by insomnia (10%) and bad dreams (10%). Average adherence as measured by drug pick-up was 99% and 3% reported a missed dose in the 3 days preceding their interview. Among participants with VL results (n = 199), 99% were virally suppressed (<1000 copies/ml), and 94% had VL <50 copies/ml at 12 months. This study is among the first to document self-reported patient experiences with DTG in sub-Saharan Africa and demonstrated high acceptability of DTG-based regimens among patients. The viral suppression rate was higher than the national average of 82%. Our findings support the recommendation of DTG-based regimen as the preferred 1L ART.
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spelling pubmed-101913602023-05-18 High acceptability and viral suppression rate for first-Line patients on a dolutegravir-based regimen: An early adopter study in Nigeria Abudiore, Opeyemi Amamilo, Ikechukwu Campbell, Jennifer Eigege, Williams Harwell, Joseph Conroy, James Jiboye, Justus Lufadeju, Folu Amole, Carolyn Wiwa, Owens Anweh, Damien Agbaji, Oche Ochai Akanmu, Alani Sulaimon PLoS One Research Article Nigeria adopted dolutegravir (DTG) as part of first line (1L) antiretroviral therapy (ART) in 2017. However, there is limited documented experience using DTG in sub-Saharan Africa. Our study assessed DTG acceptability from the patient’s perspective as well as treatment outcomes at 3 high-volume facilities in Nigeria. This is a mixed method prospective cohort study with 12 months of follow-up between July 2017 and January 2019. Patients who had intolerance or contraindications to non-nucleoside reverse-transcriptase inhibitors were included. Patient acceptability was assessed through one-on-one interviews at 2, 6, and 12 months following DTG initiation. ART-experienced participants were asked about side effects and regimen preference compared to their previous regimen. Viral load (VL) and CD4+ cell count tests were assessed according to the national schedule. Data were analysed in MS Excel and SAS 9.4. A total of 271 participants were enrolled on the study, the median age of participants was 45 years, 62% were female. 229 (206 ART-experienced, 23 ART-naive) of enrolled participants were interviewed at 12 months. 99.5% of ART-experienced study participants preferred DTG to their previous regimen. 32% of particpants reported at least one side effect. “Increase in appetite” was most frequently reported (15%), followed by insomnia (10%) and bad dreams (10%). Average adherence as measured by drug pick-up was 99% and 3% reported a missed dose in the 3 days preceding their interview. Among participants with VL results (n = 199), 99% were virally suppressed (<1000 copies/ml), and 94% had VL <50 copies/ml at 12 months. This study is among the first to document self-reported patient experiences with DTG in sub-Saharan Africa and demonstrated high acceptability of DTG-based regimens among patients. The viral suppression rate was higher than the national average of 82%. Our findings support the recommendation of DTG-based regimen as the preferred 1L ART. Public Library of Science 2023-05-17 /pmc/articles/PMC10191360/ /pubmed/37196012 http://dx.doi.org/10.1371/journal.pone.0284767 Text en © 2023 Abudiore et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Abudiore, Opeyemi
Amamilo, Ikechukwu
Campbell, Jennifer
Eigege, Williams
Harwell, Joseph
Conroy, James
Jiboye, Justus
Lufadeju, Folu
Amole, Carolyn
Wiwa, Owens
Anweh, Damien
Agbaji, Oche Ochai
Akanmu, Alani Sulaimon
High acceptability and viral suppression rate for first-Line patients on a dolutegravir-based regimen: An early adopter study in Nigeria
title High acceptability and viral suppression rate for first-Line patients on a dolutegravir-based regimen: An early adopter study in Nigeria
title_full High acceptability and viral suppression rate for first-Line patients on a dolutegravir-based regimen: An early adopter study in Nigeria
title_fullStr High acceptability and viral suppression rate for first-Line patients on a dolutegravir-based regimen: An early adopter study in Nigeria
title_full_unstemmed High acceptability and viral suppression rate for first-Line patients on a dolutegravir-based regimen: An early adopter study in Nigeria
title_short High acceptability and viral suppression rate for first-Line patients on a dolutegravir-based regimen: An early adopter study in Nigeria
title_sort high acceptability and viral suppression rate for first-line patients on a dolutegravir-based regimen: an early adopter study in nigeria
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191360/
https://www.ncbi.nlm.nih.gov/pubmed/37196012
http://dx.doi.org/10.1371/journal.pone.0284767
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