ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026
Risk of Major Adverse Cardiovascular Events With Dolutegravir Versus Efavirenz-Based Antiretroviral Therapy: Emulated Target Trials Using Routine, De-identified Data From South Africa.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
backgroundIntegrase inhibitors, including dolutegravir, may increase risk of major adverse cardiovascular events (MACEs). However, limited data exists from low- and middle-income countries, where tenofovir disoproxil fumarate, lamivudine, and dolutegravir (TLD) has largely replaced tenofovir disoproxil fumarate, emtricitabine, and efavirenz (TEE).
methodsWe used de-identified data from a South African managed healthcare organization from people with HIV (PWH) without cardiovascular disease, who either initiated TEE or TLD between April 2020 and Dec 2023 (initiation cohort) or were receiving TEE in April 2020 and eligible for TLD (transition cohort). In the initiation cohort, we emulated a target trial using pooled logistic regression models with inverse probability of treatment weights and bootstrapped CIs to compare estimated 3-year MACE risk between TLD versus TEE. In the transition cohort, we used similar methods in 44 emulated monthly sequential trials, comparing MACE risk in people transitioned to TLD with those remaining on TEE.
resultsIn the initiation cohort, 7310 PWH initiated TLD (n = 3711) or TEE (n = 3599). Median follow-up was 21 months (IQR 10-33), with 18 MACEs with TLD (3-year risk 0.78%, 95% CI .38-1.11) and 28 with TEE (3-year risk 1.03%, 0.63-1.55; RR 0.75, 0.31-1.30; RD -0.25, -0.94-0.24). In the transition cohort, 22 338 people contributed to 2837 person-trials with TLD and 706 615 with TEE. Median follow-up was 25 months (14-36), with 19 MACEs with TLD (3-year risk 0.97%, 0.52-1.62) and 5420 with TEE (3-year risk 1.17%, 0.99-1.37; RR 0.83, 0.45-1.39; RD -0.20, -0.66-0.44).
conclusionsAmong PWH in South Africa, we found no increased MACE with TLD.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.