Research Article
Prevalence of Dolutegravir Resistance Among Adults Receiving Dolutegravir-based Antiretroviral Therapy with Virological Failure in Cuba
Liuber Yans Machado*
,
Madeline Blanco,
Adriana Mesa,
Héctor Manuel Díaz,
Marta Dubed,
Neisy Valdés,
Karen Valdés,
Liodelvio Martínez,
Niurka Ramos,
Amalia Girón,
Mireida Rodríguez,
Manuel Romero,
Betsy Benítez,
María Lourdes Sánchez,
René Rodríguez,
Omar Sued
Issue:
Volume 11, Issue 1, March 2026
Pages:
1-8
Received:
25 September 2025
Accepted:
7 October 2025
Published:
7 January 2026
Abstract: Background: In late 2018, Cuba incorporated Dolutegravir, a second-generation integrase inhibitor (INSTI), into its first-line antiretroviral treatment regimens. Monitoring HIV-1 drug resistance in patients with virological failure is critical for optimizing HIV care and treatment outcomes. This study assessed the prevalence of INSTI resistance among adults experiencing virological failure while receiving Dolutegravir-based ART in Cuba. Methods: Cross-sectional analysis using programmatic data from eight healthcare facilities, representing approximately 78% of adults receiving ART in Cuba. Adults (≥18 years) receiving all individuals receiving a Dolutegravir-based ART, who presented a confirmed virological failure (two consecutive viral loads >1000 copies/mL at least three months apart) between June 2022 and December 2024, were included. Demographic and clinical data were extracted from standardized laboratory requisition forms. Blood specimens were collected for HIV drug resistance and tested by Sanger sequencing, with resistance predicted using the Stanford HIVdb tool. Results: Among 110 eligible adults, 9 (8.2%) showed INSTI resistance-associated mutations, but only 6 had high level of resistance to Dolutegravir. Acquired HIV-1 drug resistance of any type was identified in 50.0% of patients (95% CI, 40·3–59·7). Additionally, 28.2% (95% CI, 20.6–37.2) carried mutations associated with resistance to non-nucleoside reverse transcriptase inhibitors and 18·2% (95% CI, 11.5-26.7) to nucleoside reverse transcriptase inhibitors. Two patients (1.8%) were found to have multidrug-resistant virus. Conclusions: The low prevalence of Dolutegravir resistance among patients with virological failure suggests that poor adherence, rather than antiviral resistance, may be the primary contributor to unsuppressed viral load in this population. These findings underscore the need to strengthen adherence support, alongside continued surveillance to promptly detect emerging resistance.
Abstract: Background: In late 2018, Cuba incorporated Dolutegravir, a second-generation integrase inhibitor (INSTI), into its first-line antiretroviral treatment regimens. Monitoring HIV-1 drug resistance in patients with virological failure is critical for optimizing HIV care and treatment outcomes. This study assessed the prevalence of INSTI resistance amo...
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Research Article
Efficacy and Outcome of Tixagevimab-Cilgavimab Prophylaxis Administration in Kidney Transplant Patients
Issue:
Volume 11, Issue 1, March 2026
Pages:
9-16
Received:
1 December 2025
Accepted:
25 February 2026
Published:
10 March 2026
DOI:
10.11648/j.ijidt.20261101.12
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Abstract: Background: Kidney transplant recipients are immunocompromised and at high risk of developing COVID-19. Tixagevimab/cilgavimab has been shown to reduce the risk of COVID-19 in immunocompromised individuals. However, information regarding the safety and efficacy of tixagevimab/cilgavimab use in kidney transplant recipients remains limited. Therefore, in this study, we aimed to evaluate the efficacy and safety of tixagevimab/cilgavimab in individuals who have undergone kidney transplantation. Methods: A retrospective, single-center study was conducted on all patients who underwent kidney transplantation between June 2022 and January 2023. The recipients were divided into treatment and control groups based on tixagevimab/cilgavimab therapy status. The incidence of COVID-19, acute rejection, hypersensitivity reactions, and cardiac events was compared between the groups. Results: A total of 93 patients were included in the study, of whom 38 received tixagevimab/cilgavimab. Prior to drug administration, 38 patients (40.9%) were infected with COVID-19; of these, 12 (31.6%) required hospitalization and two (5.2%) required admission to the intensive care unit (ICU). During the post-administration period, seven patients (7.5%) developed COVID-19; of these patients, four (57%) received tixagevimab/cilgavimab, and three (43%) did not. None of the patients required hospitalization or ICU admission. Conclusion: The incidence of COVID-19 was similar across study groups. However, the severity of the infection appeared to be milder in patients who received tixagevimab/cilgavimab.
Abstract: Background: Kidney transplant recipients are immunocompromised and at high risk of developing COVID-19. Tixagevimab/cilgavimab has been shown to reduce the risk of COVID-19 in immunocompromised individuals. However, information regarding the safety and efficacy of tixagevimab/cilgavimab use in kidney transplant recipients remains limited. Therefore...
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