{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T02:47:45Z","timestamp":1784342865659,"version":"3.55.0"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T00:00:00Z","timestamp":1717977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>High viral load during pregnancy and breastfeeding period is the risk factor for vertical transmission of human immunodeficiency virus (HIV). Currently, Dolutegravir (DTG)-based regimens are recommended to attain adequate viral load suppression (VLS) among women. However, its effect on VLS has not been investigated among women in PMTCT care in Ethiopia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>This study aimed to investigate the rate of viral load non-suppression among women exposed to DTG-based versus Efavirenz (EFV)-based regimens in Ethiopia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>An uncontrolled before-and-after study design was conducted among 924 women (462 on EFV-based and 462 on DTG-based regimens) enrolled in PMTCT care from September 2015 to February 2023. The outcome variable was the viral load (VL) non-suppression among women on PMTCT care. A modified Poisson regression model was employed, and the proportion was computed to compare the rate of VL non-suppression in both groups. The risk ratio (RR) with a 95% confidence interval (CI) was calculated to assess viral load non-suppression among women on DTG-based and EFV-based regimens by adjusting for other variables.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>The overall rate of non-suppressed VL was 16.2% (95% CI: 14.0\u201318.8%). Mothers on DTG-based regimens had approximately a 30% (adjusted risk ratio (aRR): 0.70; 95% CI: 0.52\u20130.94) lesser risk of developing non-suppressed VL than women on EFV-based regimens. Besides, older women were 1.38 times (aRR: 1.38; 95% CI: 1.04\u20131.83); mothers who did not disclose their HIV status to their partners were 2.54 times (aRR: 2.54; 95% CI: 1.91\u20133.38); and mothers who had poor or fair adherence to antiretroviral (ARV) drugs were 2.11 times (aRR: 2.11; 95% CI: 1.45\u20133.07) at higher risk of non-suppressed VL.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Women on DTG-based regimens had a significantly suppressed VL compared to those on EFV-based regimens. Thus, administering DTG-based first-line ART regimens should be strengthened to achieve global and national targets on VLS.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0305331","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T17:35:05Z","timestamp":1718040905000},"page":"e0305331","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Viral load non-suppression status among women exposed to Dolutegravir-based versus Efavirenz-based regimens in Ethiopia: A before-and-after study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7463-524X","authenticated-orcid":true,"given":"Wolde","family":"Facha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takele","family":"Tadesse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eskinder","family":"Wolka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4840-9601","authenticated-orcid":true,"given":"Ayalew","family":"Astatkie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,6,10]]},"reference":[{"key":"pone.0305331.ref001","article-title":"HIV and AIDS, Key facts","author":"WHO","year":"2023"},{"key":"pone.0305331.ref002","article-title":"The Global HIV\/AIDS Epidemic KFF","author":"UNAIDS","year":"2023"},{"key":"pone.0305331.ref003","article-title":"Global HIV statistics","author":"UNAIDS","year":"2023"},{"key":"pone.0305331.ref004","first-page":"1","article-title":"HIV statistics, globally and by WHO region, 2023","author":"WHO","year":"2023","journal-title":"WHO, Epidemiological"},{"key":"pone.0305331.ref005","article-title":"HIV Related Estimates and Projections in Ethiopia for the Year 2021\u20132022","author":"EPHI","year":"2023","journal-title":"Addis Ababa"},{"key":"pone.0305331.ref006","article-title":"HIV and AIDS Estimates. 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Mahale","year":"2023","journal-title":"Cureus"},{"issue":"7","key":"pone.0305331.ref041","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ofid\/ofad321","article-title":"Transitioning to Dolutegravir in a Programmatic Setting: Virological Outcomes and Associated Factors Among Treatment-Naive Patients With HIV-1 in the Kilombero and Ulanga Antiretroviral Cohort in Rural Tanzania","volume":"10","author":"A. J. Ntamatungiro","year":"2023","journal-title":"Open Forum Infectious Diseases"},{"issue":"1","key":"pone.0305331.ref042","first-page":"1","article-title":"Comparative efficacy, safety and durability of dolutegravir relative to common core agents in treatment-na\u00efve patients infected with HIV-1: an update on a systematic review and network meta-analysis","volume":"21","author":"K. 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