This archive report was first published on 23 July 2019.
July 23, 2019 - The World Health Organization (WHO) has updated its recommendations for HIV treatment, strongly endorsing the use of dolutegravir (DTG) as the preferred first-line and second-line treatment for all populations, including pregnant women and those of childbearing potential.
Initial studies by the WHO highlighted a possible link between DTG and birth defects, including defects to the brain and spinal cord that cause conditions like spina bifida in infants born to women who used the drug at the time of conception.
However, new results from two large clinical trials comparing the efficacy and safety of DTG and efavirenz (EFV) in Africa have now expanded the evidence base, showing that the risks of neural tube defects are significantly lower than what the initial studies may have suggested.
“DTG is more effective, easier to administer and has fewer side effects than alternatively prescribed drugs,” said the WHO.
The WHO also noted that DTG has a high genetic barrier to developing drug resistance, which is important given the rising trend of resistance to EFV and other regimens.
As of 2018, 12 countries reported pre-treatment drug resistance levels exceeding the recommended threshold of 10 percent. This year, 82 low and middle-income countries reported that they would be transitioning to DTG-based HIV treatment regimens.
