Low-Level Viremia and Spatial Heterogeneity Among Individuals on Dolutegravir-Based Antiretroviral Therapy in Botswana: A Nationwide Study (2016–2022)

Clicks: 2
ID: 325204
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal

Ranked #295 of 427 articles by views in The Journal of infectious diseases

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 427 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
BACKGROUND: The study uses spatial analysis to identify factors associated with human immunodeficiency virus (HIV) detectable viremia in dolutegravir (DTG)-based first-line antiretroviral therapy (ART), which is crucial for targeted interventions to sustain epidemic control in Botswana. METHODS: This was a longitudinal observational cohort utilizing a dataset of 42 546 people with HIV on DTG-based first-line ART from June 2016 to December 2022 enrolled in the Botswana National Treatment Program. Detectable viremia was defined as viral load (VL) >50 copies/mL and further classified into low-level viremia (LLV; VL from 51 to 999 copies/mL) and virologic failure (VF; VL ≥1000 copies/mL). The rates of detectable viremia, LLV, and VF were stratified by year from 2017 to 2022 and mapped by districts in Botswana. Generalized estimating equation (GEE) models were utilized to evaluate odds of detectable viremia. RESULTS: There was an overall trend of increasing detectable viremia, with rates of 6.7% (2017), 5.6% (2018), 4.7% (2019), 7.1% (2020), 13.5% (2021), and 11.2% (2022) (P < .001). The linear annual trend showed that each additional year from 2017 was associated with 23% increased odds of detectable viremia and 50% increase in the odds of LLV, while odds of VF decreased by 6% per year. Repeated-measures GEE models showed that male sex (adjusted odds ratio [aOR], 1.36 [95% confidence interval {CI}, 1.30-1.43]) and rural residence (aOR, 1.10 [95% CI, 1.05-1.16]) were consistently associated with higher odds of detectable viremia, LLV, and VF over follow-up. CONCLUSIONS: While VF is declining, LLV is increasing. We observed spatial heterogeneity in detectable viremia, and higher odds in males, those with rural residence, and young individuals (18-35 years). Targeted interventions are necessary for high-risk groups and regions to further suppress viremia and achieve sustained epidemic control beyond the UNAIDS 95-95-95 targets.
Reference Key
openalex_W7203630375 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Ontlametse T. Bareng, Zvifadzo Matsena-Zingoni, Wonderful T. Choga, Goitseone Martha Lemogang, Catherine K Koofhethile, Thembinkosi M Shadreck, Ava Avalos, Bornapate Nkomo, Judith Nawa, Tony Chebani, Max Kapanda, Gaerolwe Masheto, Joseph Makhema, Sikhulile Moyo, Sally Blower, Simani Gaseitsiwe
Journal The Journal of infectious diseases
Year 2026
DOI
10.1093/infdis/jiag364
URL
https://doi.org/10.1093/infdis/jiag364
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.