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High HIV Viral Suppression Rates Achieved in Low- and Middle-Income Countries

Strategic Insights

— 1 min read

Recent research conducted at Imperial College London has made significant breakthroughs in the treatment of HIV/AIDS. The study assessed the effectiveness of the WHO-recommended first-line dolutegravir-based antiretroviral therapy (ART) in programmatic settings in low- and middle-income countries (LMICs). The research revealed that adults receiving this treatment achieved high viral suppression rates of 95% or more up to two years, meeting the UNAIDS 95% suppression target. These findings underscore the crucial role of dolutegravir-based regimens in combating HIV as a public health threat.

Key Takeaways:

  • The systematic review and meta-analysis included 22 studies from 13 countries, assessing the effectiveness of WHO-recommended first-line dolutegravir-based ART in LMICs.
  • Adults retained in care receiving WHO-recommended first-line dolutegravir-based ART achieved viral suppression rates of 95% or more up to two years, meeting the UNAIDS 95% suppression target.
  • Viral suppression was higher in those transitioning to dolutegravir-based ART compared to those initiating the treatment, with a significant difference observed at 6 months (98% vs. 94%, p < 0.001).
  • The study demonstrated the effectiveness of dolutegravir-based regimens in achieving high viral suppression rates in LMICs, aligning with the UNAIDS 95% suppression target.
  • The research highlights the importance of continued access to quality antiretroviral therapy for adults in low- and middle-income countries to combat HIV as a public health threat.

Statistics:

  • 22 studies (n = 47 to 50,742) from 13 countries were included in the systematic review and meta-analysis.
  • Viral suppression rates of 95% (95% CI: 91-97%, I²= 96%) were achieved at six months, 96% (94-98%, I² = 97%) at 12 months, and 98% (96-99%, I² = 94%) at 24 months.
  • Sensitivity analysis removing outliers decreased heterogeneity and slightly lowered the 6-month estimate (to 94%), with negligible change at 12 months.

Sources:

  • High HIV viral suppression among adults receiving WHO-recommended first-line dolutegravir-based antiretroviral therapy in low- and middle-income countries: a systematic review and meta-analysis of programmatic evidence. AIDS Research and Therapy, 2025,22(1):1-16.
  • AIDS Weekly, October 20, 2025; p 91.

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