{"doi":"10.1093/cid/ciab1006","title":"Viral Load Status Before Switching to Dolutegravir-Containing Antiretroviral Therapy and Associations With Human Immunodeficiency Virus Treatment Outcomes in Sub-Saharan Africa","abstract":"BACKGROUND: Dolutegravir is being rolled out globally as part of preferred antiretroviral therapy (ART) regimens, including among treatment-experienced patients. The role of viral load (VL) testing before switching patients already on ART to a dolutegravir-containing regimen is less clear in real-world settings. METHODS: We included patients from the International epidemiology Databases to Evaluate AIDS consortium who switched from a nevirapine- or efavirenz-containing regimen to one with dolutegravir. We used multivariable cause-specific hazards regression to estimate the association of the most recent VL test in the 12 months before switching with subsequent outcomes. RESULTS: We included 36 393 patients at 37 sites in 5 countries (Democratic Republic of the Congo, Kenya, Rwanda, Tanzania, Uganda) who switched to dolutegravir from July 2017 through February 2020, with a median follow-up of approximately 11 months. Compared with those who switched with a VL <200 copies/mL, patients without a recent VL test or with a preswitch VL ≥1000 copies/mL had significantly increased hazards of an incident VL ≥1000 copies/mL (adjusted hazard ratio [aHR], 2.89; 95% confidence interval [CI], 1.99-4.19 and aHR, 6.60; 95% CI, 4.36-9.99, respectively) and pulmonary tuberculosis or a World Health Organization clinical stage 4 event (aHR, 4.78; 95% CI, 2.77-8.24 and aHR, 13.97; 95% CI, 6.62-29.50, respectively). CONCLUSIONS: A VL test before switching to dolutegravir may help identify patients who need additional clinical monitoring and/or adherence support. Further surveillance of patients who switched to dolutegravir with an unknown or unsuppressed VL is needed.","journal":"Clinical Infectious Diseases","year":2021,"id":175975,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":22,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.811,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":352751,"name":"Jessie K. Edwards","orcid":"0000-0002-1741-335X","position":1,"is_corresponding":false},{"id":422818,"name":"Aggrey Semeere","orcid":"0000-0003-1826-2239","position":2,"is_corresponding":false},{"id":445697,"name":"Beverly Musick","orcid":"0000-0003-0334-6798","position":3,"is_corresponding":false},{"id":640605,"name":"Mark Urassa","orcid":"0000-0001-6756-9742","position":4,"is_corresponding":false},{"id":404279,"name":"Francesca Odhiambo","orcid":"0000-0002-3503-2294","position":5,"is_corresponding":false},{"id":512365,"name":"Lameck Diero","orcid":"0000-0001-9717-3570","position":6,"is_corresponding":false},{"id":718522,"name":"Charles Kasozi","orcid":null,"position":7,"is_corresponding":false},{"id":285999,"name":"Gad Murenzi","orcid":"0000-0002-5513-5522","position":8,"is_corresponding":false},{"id":576427,"name":"Patricia Lelo","orcid":null,"position":9,"is_corresponding":false},{"id":314428,"name":"Katarzyna Wyka","orcid":"0000-0002-5699-2497","position":10,"is_corresponding":false},{"id":583257,"name":"Elizabeth A. Kelvin","orcid":"0000-0002-0566-8697","position":11,"is_corresponding":false},{"id":356319,"name":"Annette H. Sohn","orcid":"0000-0002-0209-3285","position":12,"is_corresponding":false},{"id":445699,"name":"Kara Wools‐Kaloustian","orcid":"0000-0002-3277-4452","position":13,"is_corresponding":false},{"id":104608,"name":"Denis Nash","orcid":"0000-0002-3280-5386","position":14,"is_corresponding":false},{"id":705839,"name":"International epidemiology Databases to Evaluate AIDS (IeDEA)","orcid":null,"position":15,"is_corresponding":false},{"id":640720,"name":"Matthew L. Romo","orcid":"0000-0002-3038-0644","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-18T23:47:19.591542Z","pmid":"34893813","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}