Chawangwa Modongo1, Qiao Wang2, Mbatshi Dima1, Ogopotse Matsiri1, Botshelo Kgwaadira3, Goabaone Rankgoane-Pono3, Sanghyuk S Shin2, Nicola M Zetola4. 1. Botswana-UPenn Partnership, Global Health, University of Pennsylvania, Philadelphia. 2. Sue and Bill Gross School of Nursing, University of California Irvine. 3. Public Health Department, Botswana National Tuberculosis Program Ministry of Health and Wellness, Gaborone, Botswana. 4. Department of Radiation Oncology, University of Pennsylvania Philadelphia, PA.
Abstract
BACKGROUND: Dolutegravir (DTG) has recently been recommended as a preferred first-line regimen for the treatment of new and treatment-experienced HIV-infected patients. However, potential drug interactions between DTG and rifampicin remain a clinical and public health concern. METHODS: We analyzed HIV and Tuberculosis (TB) treatment outcomes of HIV-infected patients concomitantly receiving rifampicin- and DTG-based regimens under programmatic conditions in Botswana. The outcomes of interest were successful TB treatment and viral load suppression. We used multivariable logistic models to determine predictors for each outcome of interest. RESULTS: A total of 1225 patients were included in the analysis to evaluate predictors of successful TB outcome. Among patients on DTG and non-DTG regimens, 90.9% and 88.3% achieved favorable TB treatment outcomes, respectively. Of those who received DTG-based regimen; 44% received once-daily dosing and 53% twice-daily dosing. We found that DTG was associated with favorable TB treatment outcome (adjusted odds ratio = 1.56; 95% confidence interval = 1.06 to 2.31), after adjusting for age, gender, and CD4 cell counts. High rates of viral load suppression were found across all antiretroviral therapy (ART) regimen categories (>92% for all). We did not find an independent association between DTG and viral suppression after adjustment of other covariates. CONCLUSIONS: The use of DTG-based ART regimens in patients coinfected with TB and HIV lead to favorable TB and HIV treatment outcomes, comparable to those achieved with alternative ART regimens. Our results provide reassurance to TB and HIV programs about the overall programmatic concomitant use of these first-line treatment regimens for the management of HIV and TB coinfected patients.
BACKGROUND:Dolutegravir (DTG) has recently been recommended as a preferred first-line regimen for the treatment of new and treatment-experienced HIV-infectedpatients. However, potential drug interactions between DTG and rifampicin remain a clinical and public health concern. METHODS: We analyzed HIV and Tuberculosis (TB) treatment outcomes of HIV-infectedpatients concomitantly receiving rifampicin- and DTG-based regimens under programmatic conditions in Botswana. The outcomes of interest were successful TB treatment and viral load suppression. We used multivariable logistic models to determine predictors for each outcome of interest. RESULTS: A total of 1225 patients were included in the analysis to evaluate predictors of successful TB outcome. Among patients on DTG and non-DTG regimens, 90.9% and 88.3% achieved favorable TB treatment outcomes, respectively. Of those who received DTG-based regimen; 44% received once-daily dosing and 53% twice-daily dosing. We found that DTG was associated with favorable TB treatment outcome (adjusted odds ratio = 1.56; 95% confidence interval = 1.06 to 2.31), after adjusting for age, gender, and CD4 cell counts. High rates of viral load suppression were found across all antiretroviral therapy (ART) regimen categories (>92% for all). We did not find an independent association between DTG and viral suppression after adjustment of other covariates. CONCLUSIONS: The use of DTG-based ART regimens in patients coinfected with TB and HIV lead to favorable TB and HIV treatment outcomes, comparable to those achieved with alternative ART regimens. Our results provide reassurance to TB and HIV programs about the overall programmatic concomitant use of these first-line treatment regimens for the management of HIV and TB coinfectedpatients.
Authors: Nadine Albermann; Friedrich Hubertus Schmitz-Winnenthal; Kaspar Z'graggen; Christine Volk; Michael Marcus Hoffmann; Walter Emil Haefeli; Johanna Weiss Journal: Biochem Pharmacol Date: 2005-09-15 Impact factor: 5.858
Authors: Aida N Kawuma; Roeland E Wasmann; Kelly E Dooley; Marta Boffito; Gary Maartens; Paolo Denti Journal: Antimicrob Agents Chemother Date: 2022-05-23 Impact factor: 5.938
Authors: Matthew L Romo; Ellen Brazier; Dominique Mahambou-Nsondé; Reneé De Waal; Christine Sekaggya-Wiltshire; Cleophas Chimbetete; Winnie R Muyindike; Gad Murenzi; Cordelia Kunzekwenyika; Thierry Tiendrebeogo; Josephine A Muhairwe; Patricia Lelo; Anastase Dzudie; Christelle Twizere; Idiovino Rafael; Oliver C Ezechi; Lameck Diero; Marcel Yotebieng; Lukas Fenner; Kara K Wools-Kaloustian; N Sarita Shah; Denis Nash Journal: J Int AIDS Soc Date: 2022-07 Impact factor: 6.707
Authors: Kairoonisha Mahomed; Carole L Wallis; Liezl Dunn; Shavani Maharaj; Gary Maartens; Graeme Meintjes Journal: South Afr J HIV Med Date: 2020-07-02 Impact factor: 2.744
Authors: A Dravid; T P Betha; A K Sharma; R Gawali; U Mahajan; M Kulkarni; C Saraf; S Kore; M Dravid; N Rathod Journal: HIV Med Date: 2020-07-20 Impact factor: 3.180