{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:15:05Z","timestamp":1788513305168,"version":"build-2803163510"},"reference-count":26,"publisher":"Oxford University Press (OUP)","funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["GH002038"],"award-info":[{"award-number":["GH002038"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["NU2GGH001945"],"award-info":[{"award-number":["NU2GGH001945"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["NU2GGH002132-02"],"award-info":[{"award-number":["NU2GGH002132-02"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["GH002375"],"award-info":[{"award-number":["GH002375"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dolutegravir (DTG)-based regimens (DBR) account for &amp;gt;97% of antiretroviral drugs dispensed through President's Emergency Plan for AIDS Relief. Understanding factors associated with DTG drug resistance (DR) is critical to safeguarding its long-term efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included adults on DBR from cohorts in Malawi, Mozambique, Uganda, and Ukraine (2020\u20132022) with successful genotypes. DTG DR was defined as Stanford HIV Drug Resistance Database genotypic susceptibility score &amp;gt; 15. Logistic regression assessed associations between DTG DR and clinical\/sociodemographic factors, reporting odds ratios (ORs) and 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median age was 36.2 years; 59% were female; 89% transitioned to DTG from a prior regimen. In a multivariable analyses including findings from genotype test, male sex (OR 2.02, 95% CI 1.10\u20133.73), any nucleoside reverse transcriptase inhibitor (NRTI) resistance (OR 31.17, 95% CI 12.93\u201375.14), and any non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance (OR 2.56, 95% CI 1.12\u20135.88) were associated with DTG DR. After excluding genotype-derived variables, male sex remained associated with DTG DR (OR 2.13, 95% CI 1.28\u20133.54), while participants receiving zidovudine-containing backbones had higher odds of DTG DR compared with those receiving tenofovir-containing backbones (OR 5.87, 95% CI 2.45\u201314.07). Among individuals with DTG DR, G118R was the most frequent major mutation. M184V demonstrated high sensitivity (83%) and specificity (91%) for detecting DTG resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings identify key clinical correlates of DTG resistance, including concurrent NRTI\/NNRTI resistance and zidovudine-containing regimens, which may serve as proxies for prior viral non-suppression and help inform more targeted DR testing and regimen optimization in settings where genotypic testing is not readily available.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag427","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T12:00:33Z","timestamp":1783598433000},"source":"Crossref","is-referenced-by-count":0,"title":["Correlates of Dolutegravir Resistance in Low- and Middle-Income Countries: A Combined Analysis of Drug Resistance Surveys in 4 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,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Newton","family":"Kalata","sequence":"additional","affiliation":[{"name":"Division of Global HIV and TB, US Centers for Disease Control and Prevention , Lilongwe ,","place":["Malawi"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nellie","family":"Wadonda","sequence":"additional","affiliation":[{"name":"Division of Global HIV and TB, US Centers for Disease Control and Prevention , Lilongwe ,","place":["Malawi"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement","family":"Zeh","sequence":"additional","affiliation":[{"name":"Division of Global HIV and TB, US Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Azarskova","sequence":"additional","affiliation":[{"name":"Division of Global HIV and TB, US Centers for Disease Control and Prevention , Kyiv 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