Dolutegravir based therapy showed CD4+ T cell count recovery and viral load suppression among ART naïve HIV positive individuals: A longitudinal evaluation

Abstract Background: Recently, dolutegravir (DTG)-based combined therapy, a more effective and safer first-line antiretroviral therapy (ART), has been recommended by the World Health Organization (WHO) for the treatment of Human Immunodeficiency Virus (HIV) since July 2018. However, its effectiveness in CD4+ T-cells count recovery and viral load suppression has not been studied yet in Ethiopia, where HIV is endemic. Therefore, we aimed to assess the effect of DTG-based therapy on CD4+ T-cell count and viral load count among HIV-positive patients in Ethiopia. Methods: A longitudinal prospective cohort study was conducted from July 2020–February 2021. 109 HIV-positive individuals who are ART naive but plan to initiate DTG-based therapy were recruited. HIV viral ribonucleic acid (RNA) copies were determined using a CD4+ T-cell count and quantitative polymerase chain reaction (PCR). To compute the difference in viral load and CD4+ T-cell counts between the baseline, 3rd, and 6th months, a Friedman test was used. Results: The study included 109 HIV-positive people who had never received antiretroviral medication. Participants taking DTG-based treatment showed significantly decreasing median (IQR) values of viral load count (copies/mL) from 446,812 (237,649.5–732,994.5) at baseline to 34 (23.5–46) at 3 months and 0.0 (0–19) at 6 months of treatment follow-up. Although the treatment increases the proportion of participants with HIV-1 RNA 50 copies/mL from 0 (0% at baseline) to 87 (79.8%) and 100 (91.7%) at the 3rd and 6th months of treatment, respectively, On the other hand, the CD4+ T-cell count increased significantly during treatment: median (IQR): 209 (81.5–417.5) versus 291 (132–522) versus 378 (181.–632.5) cells/L at baseline, the 3rd and 6th months of the treatment follow-up period, respectively. Conclusion: We found dolutegravir-based therapy was a promising option with high virological suppression rates and CD4+ T-cell count recovery demonstrating a restoration of cellular immunity. More over Viral load suppression rates were high after the initiation of the treatment.