EC Microbiology

In Côte d’Ivoire, the initiation or transition to dolutegravir (DTG)-based triple therapy often occurs without prior assessment of viral replication or resistance mutations to nucleoside reverse transcriptase inhibitors (NRTIs), which possess a lower genetic barrier. This cross-sectional study, conducted at the Integrated Centre for Bioclinical Research in Abidjan (CIRBA) between February 2019 and January 2022, aimed to evaluate the virological impact of switching to TDF+3TC+DTG (TLD) under real-world conditions. The study included two groups of people living with HIV-1 (PLHIV-1), each having undergone two plasma viral load measurements. One group remained on TLD throughout, while the other transitioned from TLE or TLL to TLD. Plasma HIV-1 RNA quantification was performed using Roche Cobas AmpliPrep/Cobas TaqMan or Cobas 4800 platforms (Roche Diagnostics, Mannheim, Germany), with a detection threshold of 20 copies/mL. Viral load categories were defined as: virological failure (≥1,000 copies/mL), detectable viraemia (20-999 copies/mL), and undetectable viraemia (< 20 copies/mL). Among 6,275 samples analysed, 198 patients met the inclusion criteria. The median age was 39 years, with a female predominance (sex ratio: 1.5). Following transition to TLD, the proportion of patients with undetectable viraemia increased from 62% to 73%, and virological failure decreased from 17% to 4%. These findings confirm the efficacy of DTG-based therapy, while underscoring the need for systematic virological monitoring, including plasma RNA quantification and genotypic resistance testing, to guide therapeutic transitions.

 Keywords: HIV-1; Viral Load; Dolutegravir (DTG); Antiretroviral Regimen; Therapeutic Switch; Côte d’Ivoire

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