Dataset Information

Unexpected interactions between dolutegravir and folate: randomized trial evidence from South Africa.

ABSTRACT:

Objective

Dolutegravir exposure at conception was associated with a preliminary signal of increased infant neural tube defect risk. As low maternal folate levels are linked with neural tube defects, we aimed to assess serum folate concentrations in women starting dolutegravir.

Design

We analysed serum folate concentrations from stored plasma among women enrolled in the South African ADVANCE trial.

Methods

We compared changes in mean serum folate and occurrence of low serum folate (<14.0?nmol/l) at weeks 0, 12 and 24 across study arms. In ADVANCE, 1053 treatment-naïve participants were randomized to initiate tenofovir-alafenamide/emtricitabine?+?dolutegravir (TAF/FTC?+?DTG), tenofovir-disoproxil-fumarate (TDF)/FTC?+?DTG or TDF/FTC/efavirenz (EFV).

Results

Analysis includes 406 females, mean age 31.5 years and baseline CD4+ cell count 356 cells/?l. At baseline, folate concentrations were similar across treatment arms. However, serum folate increased over 12 weeks in the TAF/FTC?+?DTG arm (+4.0?±?8.1?nmol/l), while folate concentrations decreased slightly in the TDF/FTC?+?DTG arm (-1.8?±?8.9?nmol/l) and decreased in the TDF/FTC/EFV arm (-5.9?±?8.1?nmol/l). Women taking TDF/FTC/EFV had low folate concentrations at both 12 and 24 weeks compared with the other arms (P?ConclusionUnexpectedly, no declines were noted in the dolutegravir-containing arms, and concentrations were considerably higher than in the EFV arm. The possibility that dolutegravir may block cellular uptake of folate warrants investigation.

SUBMITTER: Chandiwana NC

PROVIDER: S-EPMC7810415 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Unexpected interactions between dolutegravir and folate: randomized trial evidence from South Africa.

Chandiwana Nomathemba C NC Chersich Matthew M Venter W D François WDF Akpomiemie Godspower G Hill Andrew A Simmons Bryony B Lockman Shahin S Serenata Celicia M CM Fairlie Lee L Moorhouse Michelle A MA

AIDS (London, England) 20210201 2

<h4>Objective</h4>Dolutegravir exposure at conception was associated with a preliminary signal of increased infant neural tube defect risk. As low maternal folate levels are linked with neural tube defects, we aimed to assess serum folate concentrations in women starting dolutegravir.<h4>Design</h4>We analysed serum folate concentrations from stored plasma among women enrolled in the South African ADVANCE trial.<h4>Methods</h4>We compared changes in mean serum folate and occurrence of low serum ...[more]

PMID: 33086234

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Dataset Information

Unexpected interactions between dolutegravir and folate: randomized trial evidence from South Africa.

Objective

Design

Methods

Results

Publications

Unexpected interactions between dolutegravir and folate: randomized trial evidence from South Africa.

Similar Datasets

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