Page 6 - Nursing Matters June 2021 Vol 12

Dolutegravir and the viral load

B Bosch, MBChB
E Bhaskar, MBChB
Ezintsha, a sub-division of Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg

Introduction Dolutegravir include a higher barrier to developing
drug resistance, the option for once daily
South Africa, home to the largest HIV Dolutegravir (DTG) belongs to an dosing and widespread availability in a
epidemic in the world, has an estimated antiretroviral (ARV) drug class known fixed dose combination.
population of 7.5 million people living as the integrase strand inhibitors (InSTI),
with HIV (PLWH). Of this population, which prevent viral replication by blocking As a drug class, the side effects associated
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70% are currently receiving antiretroviral the viral enzyme integrase, which in with InSTI use are mild, largely self-
therapy (ART) ensuring the world’s largest turn prevents HIV viral material from limiting and rarely lead to treatment
ART programme with ongoing efforts merging with the DNA of the patient’s discontinuation. Side effects commonly
to improve accessibility and tolerability cells. Other drugs in this class include include neuropsychiatric symptoms such
2,3
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of treatments available. The recent cabotegravir, bictegravir, elvitegravir and as insomnia, headaches and dizziness;
introduction of dolutegravir (DTG) into raltegravir (RAL). Of these, only DTG and and occasionally gastrointestinal
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public healthcare programmes in South RAL are available in public healthcare disturbances. Two adverse events of
Africa in 2019 has brought with it hope for programmes in South Africa and DTG concern include InSTI-related weight gain
better tolerated, less brittle ARV regimens. is preferred for several reasons. These and the potential for neural tube defects

HIV Nursing Matters | June 2021 | page 4