Multi-country CohortActive

Ndovu Cohort Study

Investigating the optimal management of dolutegravir resistance across four African countries — Kenya, Mozambique, Tanzania, and Lesotho.

Duration

12 months

Participants

392

Countries

4 countries

Study Design

Multi-country observational prospective cohort study over 12 months, describing HIV-1 viral suppression in 392 individuals with high viral load (≥ 1,000 copies/mL) after at least six months on DTG-based ART. The study assesses viral suppression rates following enhanced adherence counseling across four African countries.

Target population: Individuals living with HIV from four African countries with high viral load on DTG-containing antiretroviral regimens.

Primary Endpoint

Viral suppression rate following enhanced adherence counseling

Study Objectives

Describe HIV-1 viral suppression rates in people with high viral load after enhanced adherence counseling

Investigate patterns of dolutegravir resistance mutations across different African populations

Assess factors associated with treatment success and failure in DTG-based regimens

Evaluate the effectiveness of enhanced adherence counseling interventions

Document real-world outcomes of DTG-based therapy in resource-limited settings

Build evidence for optimal management strategies of DTG treatment failure

Eligibility Criteria

Inclusion

Be at least 1 year of age

Consent to participate in the study

Have documented HIV infection

Be on a DTG-based regimen for at least 6 months

Have an HIV-1 RNA level of ≥ 1,000 copies/mL

Exclusion

Individuals who cannot provide a sample for viral load testing

Anyone currently taking concomitant PIs/NNRTIs while on DTG

Study Procedures
1

Screening and enrollment of eligible participants with high viral load

2

Baseline assessments including viral load, CD4 count, and resistance testing

3

Enhanced adherence counseling sessions delivered by trained staff

4

Regular follow-up visits at 3, 6, and 12 months

5

Repeat viral load and resistance testing at specified timepoints

6

Collection of demographic, clinical, and behavioral data

7

Assessment of treatment adherence and barriers to care

8

Documentation of clinical outcomes and adverse events