Background: Antiretroviral therapy (ART) has significantly increased the lifespan of people living with HIV. Currently, fixed dosed combination therapy (Tenofovir, Lamivudine, and Dolutegravir) is being introduced in most countries in the Sub- Saharan Africa. There is need for a clinical and immunological assessment of HIV patients transitioned to this new therapy over a period of 2 years.
Objectives: To determine the proportion of patients whose viral load was suppressed to <20 copies/ml following two years therapy with Dolutegravir-based fixed-dose combination therapy.
Methods: This retrospective cohort study was carried out in a Comprehensive Healthcare Centre (CHC), a facility affiliated with Nnamdi Azikiwe University Teaching Hospital Nigeria. The primary outcome measure was the proportion of patients whose viral load was suppressed to <20 copies/ml. The plasma viral load (HIV-RNA) assay was done using real time PCR and CD4+ T- lymphocyte (CD4+) counts were estimated using Flow Cytometry. The exclusion criteria were patients who has invalid data base and patients with comorbidities associated with HIV.
Results: A total of 537 HIV1 sero-positive patients were enrolled for ART care over a period of 2 years (2017-2018). Females in the age group (41-50 years) constituted the bulk (36.9%) of the patients whilst the least (5.3%) were males in the age group (8 to 30 years). The mean CD4 count of patients was 847.35cells/mm3. More females (45.9%) had CD4+counts over 500cells/mm3 whilst the percentage of males with CD4+ cell counts over 500cells/mm3 was 43.8%. Majority, 405 constituting 75.4% of the patients have suppressed viral load (<20 copies/ml) signifying that the centre is achieving success with respect to service delivery and ART. Patients with unsuppressed viral loads were more among Females with CD4+ counts in the range of 200-499 cells/mm3and this may be as a result of other associated factors which will be elucidated in future studies.
Conclusion: Dolutegravir-based fixed-dose combination therapy suppressed viral load to <20 copies/ml in more than 75% of patients receiving the therapy. Enhanced adherence and effective doctor-patient relationship could be associated with the viral suppression observed in this study.
Key words: Immunology, virology, HIV Outcome, Dolutegravir-based combination therapy, anti retroviral therapy.
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