Efficacy and safety of dolutegravir versus Efavirenz based first line anti-retroviral regimen Among hiv positive patients at jimma medical center, Jimma, southwest ethiopia, 2020

Abstract

Background: Dolutegravir (DTG) is a once-daily unboosted second-generation novel HIV-1 entry and integrase strand transfer inhibitors with that along with two nucleoside reverse transcriptase inhibitors (NRTI) preferred first line that is in use in Ethiopia in 2018. Objective: To assess the efficacy and safety of Dolutegravir based first line Antiretroviral Therapy regimens compared with Efavirenz based regimen among HIV-positive Patients in Jimma Medical Center, 2020. Methods: This study was facility-based retrospective cross-sectional study among newly diagnosed HIV patients starting ARV drugs with TDF+3TC+DTG and TDF +3TC+EFV at Jimma medical center, who were started ART from August 2018 to April 2020. Data was collected from patients’ chart. Data was edited, coded, entered into Epi data and then exported to SPSS version 20 for cleaning and analysis respectively. The data were summarized and described using tables, graphs and percentages. Descriptive statistics were used to put results of the study in the form of findings and percentages. Bivariate association was assessed by using chi-square test for categorical variables and t-test for continuous variables. Result: 240 patient charts were reviewed, which comprised of equal number of Patients on TLD and TLE. The mean age of the study subjects was 34.78±11.99 and 36.7±9.92 years among the TLD and TLE groups respectively. The distribution of age, sex, residency, marital status, educational level and occupation of the study groups was similar. The TLD treatment group showed better CD4 recovery than the TLE group. An independent sample t test reported a significant difference in mean CD4 change among HIV patients receiving TLD and TLE regimens, t (238) = 3,747, p <.001, 95% C.I. [24.49–78.78]. There is a statistically significant relationship between the regimen and viral suppression (p=0.029). 72.5%, n=87 of the patients’ viral load that were recruited for TLD were suppressed as compared to that of TLE (59.17%, n=71). Conclusion: The efficacy and safety of TLD were superior over TLE regimen for the treatment of newly diagnosed HIV patients with lower side effects. Recommendation: TLD, including DTG containing regimens should be monitored regularly, and the current TLD containing treatment regimens in Ethiopia should be strengthened to get benefitted