The impact of transitioning to Dolutegravir on the mental well-being of clients receiving ART in district hospitals of Butha-Buthe in Northern Lesotho was investigated in an open-cohort study. The study aimed to evaluate patient outcomes after transitioning from a non-Integrase Strand Transfer Inhibitor (INSTI)-based regimen to a Dolutegravir (DTG)-based one. The DO-REAL study (Dolutegravir in Real Life) commenced enrolment of clients, including people transitioning from previous ART regimens to a DTG-containingone, as well as ART-naive patients initiating DTG-containing regimens.

People with HIV commonly experience mental health issues, particularly depression, which can manifest as fatigue, sleep disturbances, and overall diminished well-being. Studies in Malawi have highlighted neuropsychiatric problems among HIV-positive clients on Efavirenz, underscoring concerns about its use in those with underlying mental illness. HIV and Dolutegravir use also adversely affects quality of life, comparable to other chronic conditions.

This research was nested in the broader DO-REAL study, aiming to assess the benefits and risks of implementing DTG in first-line regimens. It evaluated rates of viremia, drug resistance and the prevalence and severity of symptoms and side effects over 24 months.