Comparative clinical outcomes of efavirenz and dolutegravir based antiretroviral therapy in a tertiary care hospital

Abstract

Objective: The two main parameters used in HIV monitoring are CD4 cell count and viral load. This monitoring also helps determine when patients need to start, change, or stop antiretroviral therapy (ART). This study aims to analyze the differences in clinical parameter outcomes between HIV/AIDS patients receiving TDF-3TC-EFV and TDF-3TC-DTG at Dr. M. Djamil Padang General Hospital, by calculating the Odds Ratio (OR) value as a comparative measure. Method: This study used an observational analytical design with a cross-sectional approach, conducted at Dr. M. Djamil Hospital, Padang, from August to September 2025. Clinical and sociodemographic data were collected through electronic medical records and questionnaires. The analysis involved 134 samples for CD4 parameters and 118 samples for viral load. Data were analyzed using the Chi-Square test to assess the relationship between variables and the Odds Ratio to measure the level of risk. Results: The majority of respondents were men aged 30–49 years. Sociodemographic characteristics did not show a significant association with the type of antiretroviral regimen (p> 0.05). Clinical analysis revealed a highly significant association between CD4 count and regimen type (p = 0.000), but no significant association with viral load parameters (p=0.172). The TDF-3TC-EFV regimen was associated with a 16-fold higher risk (OR = 16.014; 95% CI: 2.193–116.935) of experiencing immune reconstitution failure (CD4 count below normal) compared to the TDF-3TC-DTG regimen. Conversely, TDF-3TC-DTG significantly showed a protective effect by reducing this risk (OR = 0.765; 95% CI: 0.667–0.879). Conclusion: The study demonstrated superiority of the TDF-3TC-DTG regimen in increasing CD4 counts compared to TDF-3TC-EFV, although the difference in viral load was not statistically significant. These findings provide important guidance on therapy response and the associated changes in CD4 and viral load. Consequently, the DTG regimen could be a primary option for boosting patient immunity, with long-term risk monitoring. Further studies with a larger sample size are needed for confirmation.

Access to Document

Other files and links

• Link to publication in Scopus
• Open Access Version Available

Fingerprint