Brazil’s national treatment program revealed that people taking dolutegravir-based antiretroviral treatment would most likely have a fully suppressed viral load six months after treatment at the 22nd International AIDS Conference in Amsterdam on July 24.
Dolutegravir has outstanding results compared to other antiretrovirals. It was introduced in Botswana in 2016 as a first-line antiretroviral therapy for adults with HIV, including pregnant women. This research was published on the NEJM Journal Watch website by Salim S. Abdool Karim, M.D., Ph.D.
According to aids.info.nih.gov, “Dolutegravir belongs to a class (group) of HIV drugs called integrase inhibitors. Integrase inhibitors block an HIV enzyme called integrase. (An enzyme is a protein that starts or increases the speed of a chemical reaction.) By blocking integrase, integrase inhibitors prevent HIV from multiplying and can reduce the amount of HIV in the body.”
After its 2013 FDA approval, dolutegravir is on the market and available under the brand name Tivicay, with a recommended dosage of once or twice a day.
Brazil’s ministry of health ran several tests before coming their conclusion, including an analysis of viral suppression six months after starting treatment. Their test subjects included over 100,000 people over 15-years old — majority were men — who began treatment from January 2014 to July 2017.
“Viral suppression rates six months after starting treatment ranged from 63.7% in those who started treatment on the regimen of tenofovir, lamivudine and lopinavir/ritonavir (2% of the cohort) to 85.2 percent in those who started treatment with tenofovir, lamivudine and dolutegravir (7.2 percent).”
In 2017, Brazil’s national treatment program became one of the first to adopt dolutegravir-based treatment as the preferred option for first-line therapy. Now, dolutegravir—in a three-drug combination—is available in 92 low-income countries for about $75 a year.