Outcomes of Dolutegravir-Based Antiretroviral Therapy in Thai Youth Aged 18 to 24 Years Living with HIV in Bangkok: A Retrospective Cohort Study
Wipaporn Natalie Songtaweesin¹,², Chutima Saisaengjan², Jiratchaya Soponphan³, Patama Deeklum², Rachaneekorn Nadsasarn², Lucksanapon Pitikawinwong², Chayapa Phasomsap², Thanyawee Puthanakit¹,⁴
Affiliation : ¹ School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; ² Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; ³ HIV Netherlands Australia Thailand (HIV-NAT) Research Collaboration, Thai Red Cross AIDS Research Center, Bangkok, Thailand; ⁴ Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Objective: Dolutegravir (DTG) is recommended globally for people living with HIV. The present study aimed to describe the efficacy and safety of DTG-based regimens among youth aged 18 to 24 years.
Materials and Methods: A retrospective cohort study was conducted among youth aged 18 to 24 years living with HIV at Chulalongkorn Hospital. Participants were divided into antiretroviral naïve (AN), antiretroviral experienced with treatment failure (AETF), and antiretroviral experienced and virally suppressed (AEVS). DTG was prescribed as a daily individual tablet or as part of a fixed-dose combination. The primary outcome was virological suppression defined as VL of less than 200 copies/mL within 12 months after DTG initiation. Secondary outcomes included body weight and lipid profile changes.
Results: Between 2017 and 2022, 87 youth with a median age of 20.6 (IQR 19.6 to 21.9) years were initiated on DTG. Fifty-six (64.3%) were male. Twelve participants were AN, 18 were AETF, and 57 were AEVS. HIV viral suppression was 100% and 96.2% among those AN and AEVS, but only 54.5% amongst the AETF group (p<0.001). CD4 lymphocyte counts increased in all groups at follow-up. Median body weight change was +0.4 (IQR –1.8 to 3.6) kg in males and +0.5 (IQR –2.8 to 1.7) kg in females. Median total cholesterol declined from 167 (IQR 142 to 186) to 152 (IQR 135 to 170) mg/dL, p=0.003. Median triglycerides declined from 83 (IQR 60 to 129) to 66 (IQR 46 to 78), p<0.001. No hospitalizations or mortalities were observed in the study.
Conclusion: DTG was effective and well-tolerated in youth living with HIV, with no significant weight gain and improved lipid profiles. DTG implementation among youth living with HIV should be continued.
Received 11 July 2023 | Revised 1 September 2023 | Accepted 15 September 2023
DOI: 10.35755/jmedassocthai.2023.10.13897
Keywords : Dolutegravir; Antiretroviral therapy; Adolescents living with HIV
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