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

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

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

Tom Loosli et al. Clin Infect Dis. 2025.

. 2025 May 20:ciaf204.

doi: 10.1093/cid/ciaf204. Online ahead of print.

Authors

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.

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Conflict of interest statement

Potential conflicts of interest . R. D. K. has received financial support (payment to the institution) for the present work from the NIH NIAID and has received grants from Gilead Sciences. R. L. has received financial support (payment to the institution) for the present work from the NIH NIAID and has received grants (payment to institution) from the NIH NIAID for an unrelated project. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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

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

Authors

Affiliations

Abstract

Conflict of interest statement

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