Drug Resistance in People With Viremia on Dolutegravir-based Antiretroviral Therapy in Sub-Saharan Africa: The DTG RESIST Study

Tom Loosli; Carolyn Bolton Moore; Lydia Buzaalirwa; Helen Byakwaga; İpek Çelikağ; Cleophas Chimbetete; Peter Vanes Ebasone; Jennifer Giandhari; Nuri Han; Jacqueline Huwa; Charles Kasozi; Adolphe Mafoua; Eugène Messou; Albert Minga; Guy Muula; Winnie Muyindike; Arcel Christ Massamba Ndala; Mamatha Sauermann; Aggrey Semeere; Lavanya Singh; Roger D Kouyos; Richard Lessells; Matthias Egger

doi:10.1093/cid/ciaf204

Drug Resistance in People With Viremia on Dolutegravir-based Antiretroviral Therapy in Sub-Saharan Africa: The DTG RESIST Study

Clin Infect Dis. 2025 May 20:ciaf204. doi: 10.1093/cid/ciaf204. Online ahead of print.

Authors

Tom Loosli^{1

2}, Carolyn Bolton Moore^{3

4}, Lydia Buzaalirwa⁵, Helen Byakwaga⁶, İpek Çelikağ⁷, Cleophas Chimbetete⁸, Peter Vanes Ebasone⁹, Jennifer Giandhari¹⁰, Nuri Han^{1

2}, Jacqueline Huwa¹¹, Charles Kasozi¹², Adolphe Mafoua¹³, Eugène Messou¹⁴, Albert Minga¹⁵, Guy Muula³, Winnie Muyindike⁶, Arcel Christ Massamba Ndala¹⁶, Mamatha Sauermann⁷, Aggrey Semeere¹⁷, Lavanya Singh¹⁰, Roger D Kouyos^{1

2}, Richard Lessells^{10

18}, Matthias Egger^{7

19

20}

Affiliations

¹ Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
² Institute of Medical Virology, University of Zurich, Zurich, Switzerland.
³ Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
⁴ Center for AIDS Research, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
⁵ AIDS Healthcare Foundation Uganda Cares, Masaka, Uganda.
⁶ Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
⁷ Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
⁸ Newlands Clinic, Harare, Zimbabwe.
⁹ Hôpital Jamot, Yaoundé and Regional Hospital, Limbé, Cameroon.
¹⁰ KwaZulu-Natal Research Innovation and Sequencing Platform, University of KwaZulu-Natal, Durban, South Africa.
¹¹ Lighthouse Trust, Lilongwe, Malawi.
¹² Public Health Department, Regional Referral Hospital, Masaka, Uganda.
¹³ Centre de Traitement Ambulatoire, Pointe Noire, Republic of the Congo.
¹⁴ Centre de Prise en Charge, de Recherche et de Formation, Abidjan, Côte d'Ivoire.
¹⁵ Centre National de Transfusion Sanguine, Abidjan, Côte d'Ivoire.
¹⁶ Centre de Traitement Ambulatoire, Brazzaville, Republic of the Congo.
¹⁷ Infectious Diseases Institute, Makerere University, Kampala, Uganda.
¹⁸ Centre for the AIDS Programme of Research in South Africa, Durban, South Africa.
¹⁹ Centre for Infectious Disease Epidemiology and Research, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
²⁰ Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.

PMID: 40391923
DOI: 10.1093/cid/ciaf204

Abstract

Dolutegravir resistance is an increasing concern. An analysis of the DTG RESIST study found that among 227 integrase sequences from 7 African countries (all non-B subtypes), 59 (26.0%) had at least 1 major drug resistance mutation (primarily G118R and E138A/K/T), with 49 (21.6%) predicted to have high-level resistance to dolutegravir.

Keywords: HIV; dolutegravir; drug resistance; sub-Saharan Africa; viremia.

Abstract

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