Based on new evidence assessing benefits and risks, the World Health Organisation (WHO) has recommended the use of the HIV drug dolutegravir (DTG) as the preferred first-line and second-line treatment for all populations, including pregnant women and those of childbearing potential.
According to a release, initial studies had highlighted a possible link between DTG and neural tube defects (birth defects of the brain and spinal cord) in infants born to women using the drug at the time of conception.
“But new data from two large clinical trials comparing the efficacy and safety of DTG and efavirenz (EFV) in Africa have now expanded the evidence base. The risks of neural tube defects are significantly lower than what the initial studies may have suggested,’’ the release said.
It noted that DTG is more effective, easier to take and has fewer side effects than alternative drugs. It also has a high genetic barrier to developing drug resistance, which is important, given the rising trend of resistance.
In 2019, 12 of the 18 countries surveyed by WHO reported pre-treatment drug resistance levels exceeding the recommended threshold of 10%.
All the above findings informed the decision to update the 2019 guidelines, WHO noted.
In 2019, 82 low- and middle-income countries reported to be transitioning to DTG-based HIV treatment. The new recommendations aim at helping more nations improve their HIV policies.