Discussion
toxicity, weight gain
This study with HIV-1-infected ART-naïve TGW showed that 77% met the protocol definition of retention (at week 48) after their initial prescription of drug regimen comprising DTG plus TDF-FTC or 3TC. Likewise, 72% and 97% of participants showed viral suppression at week 48 in ITT and per-protocol analyses, respectively. The regimen had low toxicity, good tolerance and high adherence (about 95%).Although retention and viral suppression figures are below the UNAIDS recommended goals, they still represent an achievement in this challenging group of patients. In fact, studies from Latin America show lower rates of retention among TGW. A respondent-driven sampling study among TGW in Brazil that aimed to estimate the HIV cascade of continuum of care showed that 67.2% reported linkage to care [Baseline characteristics of the sample show a high level of psychosocial vulnerability. One third of the participants (30%) were foreign-born, half of them reported unstable housing, and a high proportion was engaged in sex work for a living. These factors, among others, may increase mobility and, therefore, the risk of being lost to follow-up in HIV care [Age was one of the factors associated with retention in this sample of TGW. Older TGW are more likely to be retained in the study than younger ones. In relation to this, older TGW may have a history of approaching the healthcare system seeking gender-affirming medical procedures (e.g., hormone therapy), which then facilitates access to other healthcare services that they may need, such as HIV care [Adherence to ART is affected by a range of factors, among them, the AEs associated with chronic therapy [The absence of a control arm did not allow us to draw conclusions about efficacy of once-daily DTG-based ARV-naïve patients. However, in this single-arm study, this regimen achieved viral suppression in 72% of 45 patients by ITT analysis and 97% in the analysis per-protocol. Given that the number of “non-suppressed” participants was very small, an exploratory analysis of possible correlates of this condition could not be conducted, as required statistical parameters were not achieved.In the course of DTG-based ART, an unexpected excess in weight gain has been reported [In Argentina, gender identity stigma from healthcare workers is associated with avoidance of TGW to attend healthcare services [