Effect of dolutegravir-based drug combinations on the level of medication adherence and viral load among adolescents living with HIV in resource-limited setting: a pre-post design.

Journal: International journal of adolescent medicine and health

Volume: 35

Issue: 6

Year of Publication: 2023

Affiliated Institutions:  Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria. Department of Mental Health, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria. Department of Family Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria. Department of Hematology and Immunology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria. Department of Pharmacy, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria. Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria. Department of Internal Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria.

Abstract summary 

The use of antiretroviral drugs among HIV-infected adolescents has been challenged with poor medication adherence, leading to an unsuppressed viral load and ultimately to drug resistance. Recently, dolutegravir has been approved for use in adolescents with HIV, but the evidence on medication adherence and viral load suppression is limited. The study determined the effect of dolutegravir-based drug regimens on the level of medication adherence and viral load among treatment-experienced adolescents.A longitudinal pre-post design study was done among adolescents living with HIV at a paediatrics clinic in Nigeria. Assessment of medication adherence and viral load testing was done before and at six months of transitioning to dolutegravir-based regimens. McNemar-chi-square was used to determine the effectiveness of the drug on adherence and viral load suppression. Multivariate logistic regression analysis was performed to determine the predictors of drug adherence and viral suppression.The mean age of the participants was 14.7 years (SD=3.2), and 53.3 % were males. The mean duration of ART use was 10.3 years (SD=3.2). Six months after transitioning to dolutegravir, there was a significant decrease in viral load (Z=-7.947, p<0.001) and an increase in medication adherence score (Z=-7.554, p<0.001), among the treatment-experienced adolescents. Viral suppression was 13 times higher among respondents with good medication adherence as compared to those with poor medication adherence (AOR=13.24, CI=3.25-53.90).Dolutegravir is effective in improving medication adherence and viral suppression among Adolescents living with HIV. Thus, the need to transition eligible adolescents to dolutegravir to sustain better treatment outcomes.

Authors & Co-authors:  Ezenwosu Ifeyinwa L IL Onu Justus U JU Chukwuma Uchenna V UV Onwuka-Kalu Chima C Omotola Olusegun F OF Ezenwosu Osita U OU Chukwuka Chinwe J CJ

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Joint United Nations Programme on HIV/AIDS (UNAIDS) . Global HIV & AIDS statistics—fact sheet . https://www.unaids.org/en/resources/fact-sheet [Accessed 19 Feb 2023].
Authors :  7
Identifiers
Doi : 10.1515/ijamh-2023-0082
SSN : 2191-0278
Study Population
Male
Mesh Terms
Male
Other Terms
adolescents;dolutegravir;drug adherence;viral suppression
Study Design
Longitudinal Study,Cross Sectional Study
Study Approach
Country of Study
Niger
Publication Country
Germany