Students Research in Progress
Sunday, October 13, 2024
12:45 PM–02:15 PM
Abstract
Introduction:
Ukraine has the second-highest rate of HIV infection in Eastern Europe and Central Asia, necessitating the optimization of antiretroviral therapy (ART) to meet UNAIDS' 90-90-90 goals. The integration of dolutegravir (DTG) as a first-line regimen was used to improve treatment efficacy, reduce viral rebound, and enhance compatibility with opioid substitution therapy among people living with HIV (PLWH) who inject drugs.
Research Question or Hypothesis:
This study aims to assess whether dolutegravir has a lower incidence of viral rebound (VR) compared to efavirenz (EFV) and ritonavir-boosted lopinavir (LPV/r) among ART-naive and ART-experienced individuals.
Study Design:
A convergent mixed-method design was used to evaluate the treatment outcomes of DTG-based regimens versus EFV- or LPV/r-based treatments.
Methods:
Data was collected from Ukraine’s HIV Medical Information System, involving 23 PEPFAR ART sites. Participants were categorized into DTG-naive, switched from a previous ART, or using alternative treatment regimens.
Results:
Out of 38,840 participants, 25,471 (66%) were included, with 963 (3.8%) experiencing VR. In treatment-naive groups, VR rates were 3.1% (DTG), 8.7% (LPV/r), and 3.7% (EFV). In treatment-experienced groups, VR rates were 4.1% (DTG), 5% (LPV/r), and 3.4% (EFV).
Conclusion:
Ongoing investigations will use logistic regression for bivariable and multivariable analysis, with the primary endpoint being HIV viral rebound (>200 copies/ml) after documented suppression. Dolutegravir demonstrates reduction in viral rebound among both ART-naive and ART-experienced individuals compared to EFV and LPV/r. These findings support the continued use of DTG in optimizing ART regimens, particularly in populations with high rates of opioid use dependency.
Keywords: Dolutegravir, HIV, Antiretroviral therapy, Viral rebound, Opioid substitution therapy, Ukraine
Presenting Author
Karina Babina BS, PharmD/MS CandidateUniversity at Buffalo
Authors
Raymond Cha BS Pharmacy, PharmD
University at Buffalo
Jack DeHovitz MD, MPH, MHCDS
SUNY Downstate Health Sciences University
Kostyantyn Dumchev MD, MPH
Ukrainian Institute on Public Health Policy
Myroslava Germanovich Senior Research Specialist
Alyona Ihnatiuk MPH
International Training & Education Center for Health
Tetiana Kiriazova PhD
Ukrainian Institute on Public Health Policy
Gene Morse PharmD
University at Buffalo
Gina M. Prescott PharmD, BCPS, FCCP
University at Buffalo
Serhiy Riabokon MD
Public Health Center of the Ministry of Health of Ukraine
Anna Shapoval EdD
International Training & Education Center for Health
Gregory Wilding PhD
University at Buffalo
Jingtao Zhu MA, PhD Candidate
University at Buffalo