Dolutegravir and the management of HIV/AIDS in the South African adult population

Abstract

The safety and efficacy of medicines are important considerations in antiretroviral treatment programmes. Previous first-line regimens that showed initial success have subsequently demonstrated several resistance pathways. Newer medicines such as dolutegravir have the potential to provide a safer and more effective management option for HIV/AIDS patients. This paper aims to provide an overview of dolutegravir and its role in the management of HIV/AIDS in the adult population, addressing the limitations and challenges faced by previous treatment regimens within the South African context. Information in this review was obtained from peer-reviewed articles and organisations’ reports related to dolutegravir. We established as the main finding that dolutegravir has a higher genetic barrier to resistance, superior efficacy, tolerability, and durability. However, initial clinical trials, funded by the manufacturer, were done in well resourced countries. With the high levels of non-nucleoside reverse transcriptase inhibitor resistance and the need for countries to incorporate dolutegravir into national treatment guidelines, poorly resourced countries need to collect further data on its safety and efficacy. Dolutegravir holds great promise and is currently a key medicine in the treatment of HIV/AIDS in the South African population. Findings from this review highlight the importance of dolutegravir being incorporated into national treatment guidelines and the need for ongoing safety data.