Population Effectiveness of Dolutegravir Implementation in Sub-Saharan Africa: A Prospective Observational Cohort Study (DISCO)

  • Effective start/end date: January 02nd, 2018 September 01st, 2024
  • Funder: NIH
  • Type: Intevation Research


The DISCO study is a prospective observational cohort study at government-supported HIV clinics in rural South Africa and Uganda, which began in 2019. In the first phase of the study, we enrolled adults with HIV who are switched from first-line antiretroviral therapy (ART) containing non-nucleoside reverse transcriptase inhibitors (NNRTIs) to a regimen containing tenofovir, lamivudine and dolutegravir (TLD) as part of national guidelines. In the second phase of the study, we are enrolling treatment-naïve adults with HIV who are initiating ART with TLD. We follow participants for one year with study visits at enrollment, 24 weeks, and 48 weeks. Study procedures include interviews, anthropomorphic measurements, chart review, and collection of blood and urine specimens for retrospective testing, including viral load, drug resistance testing, antiretroviral drug level testing. The study aims to quantify viral suppression rates for adults on TLD, assess regimen tolerability of TLD, and to evaluate the determinants of virologic failure on TLD when it occurs. We expect to complete our 48-week analysis for Phase 1 study participants by the close of 2021. Recruitment of the phase 2 cohort is ongoing.


  • Dr. Suzanne M. McCluskey MD (MGH P.I)
  • Dr. Muyindike R. Winnie (MUST P.I)
  • Dr. Mark J. Siedner MD MPH (Co-Investigator)