Dolutegravir Based Therapy Showed CD4+ T Cell Count Recovery and Viral Load Suppression among Art Naive HIV Positive Individuals: A Longitudinal Evaluation
Background: Recently, Dolutegravir (DTG)-based combined therapy, a more effective and safer first-line Antiretroviral Therapy (ART), has been recommended by the World Health Organization (WHO) for the treatment of Human Immunodeficiency Virus (HIV) since July 2018. However, its effectiveness in CD4+ T-cells count recovery and viral load suppression has not been studied yet in Ethiopia, where HIV is endemic. Therefore, we aimed to assess the effect of DTG-based therapy on CD4+ T-cell count and viral load count among HIV-positive patients in Ethiopia.
Methods: A longitudinal prospective cohort study was conducted from July 2020-February 2021. 109 HIV-positive individuals who are ART naive but plan to initiate DTG-based therapy were recruited. HIV viral Ribonucleic Acid (RNA) copies were determined using a CD4+ T-cell count and quantitative Polymerase Chain Reaction (PCR). To compute the difference in viral load and CD4+ T-cell counts between the baseline, 3rd, and 6th months, a Friedman test was used.
Results: The study included 109 HIV-positive people who had never received antiretroviral medication. Participants taking DTG-based treatment showed significantly decreasing median (IQR) values of viral load count (copies/mL) from 446,812 (237,649.5- 732,994.5) at baseline to 34 (23.5-46) at 3 months and 0.0 (0-19) at 6 months of treatment follow-up. Although the treatment increases the proportion of participants with HIV-1 RNA 50 copies/mL from 0 (0% at baseline) to 87 (79.8%) and 100 (91.7%) at the 3rd and 6th months of treatment, respectively. On the other hand, the CD4+ T-cell count increased significantly during treatment-median (IQR): 209 (81.5-417.5) versus 291 (132-522) versus 378 (181-632.5) cells/L at baseline, the 3rd and 6th months of the treatment follow- up period, respectively.
Conclusion: We found Dolutegravir-based therapy was a promising option with high virological suppression rates and CD4+ T-cell count recovery demonstrating a restoration of cellular immunity. More over viral load suppression rates were high after the initiation of the treatment.