REAL-WORLD EFFICACY OF DOLUTEGRAVIR: A REVIEW OF VIROLOGICAL SUPPRESSION AND CD4+ RECOVERY TRENDS

Abstract

Background: Since its recommendation by the World Health Organization as a preferred first-line agent, Dolutegravir (DTG) has transformed HIV management due to its high genetic barrier to resistance and superior tolerability. While clinical trials have established its efficacy, there is a critical need for real-world validation of its impact on primary clinical markers during the early stages of treatment. This review evaluates the effectiveness of DTG-based antiretroviral therapy (ART) on virological outcomes and immunological recovery within the first six months of initiation. Methods: A comprehensive review of prospective and retrospective clinical data was conducted, focusing on HIV-1 infected adults (\ge18 years) initiating DTG-based regimens. The primary endpoints assessed were the rate of virological suppression (defined as HIV-1 RNA <50 or <200 copies/mL) and the mean change in CD4+ T-cell count from baseline to month 6. Secondary considerations included treatment adherence and early safety signals such as weight gain. Results: DTG regimens show rapid efficacy, with most patients achieving viral suppression within 24 weeks. This is accompanied by significant immune restoratio

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n, typically seeing CD4+ increases of 100–150 cells/mm³. While highly effective, clinicians must monitor for early metabolic changes, such as weight gain. Conclusion: The first six months of DTG-based ART are characterized by superior viral clearance and robust immune recovery, supporting its use as a potent first-line treatment.