Scientific Innovation Award

Pharmacogenetics of dolutegravir in HIV-infected subject from Botswana

Pharmacogenetics is a field of science that is rapidly gaining interest in the world of medicine. It utilises a person’s genome (or genetic makeup), to identify drugs and/or drug doses that are likely to work best for that person, or drugs and/or drug doses that are likely to cause adverse drug reactions (ADRs) (Dandara et al., 2019). It is selectively helpful in improving drug efficacy and safety. 

Maseng’s research aims to shed light on the individual genetic variations that contribute to different HIV treatment outcomes. These genetic differences significantly influence treatment outcomes by either increasing or decreasing the plasma drug levels causing adverse effects or treatment failure with or without drug resistance respectively. She will be evaluating drug-gene interactions in HIV-1 infected individuals taking dolutegravir (DTG) based regimen in Botswana and hopes to find gene components that contribute towards the various DTG plasma concentration that might be high risk for development of drug resistance.

By understanding these interactions, Maseng and her team can pave way for the development of tailored prevention and treatment methods. This tailored approach, rooted in the principles of pharmacogenetics, ensures efficient and safe treatments, minimising the risks of side effects and drug resistance. This underscores the importance of personalised treatment strategies, emphasising the significance of dosage adjustments based on individual genetic profiles. By adopting this approach, they can optimise therapeutic outcomes, ultimately improving the effectiveness of treatments for HIV, TB, malaria, and other chronic infections.

In regions like Sub-Saharan Africa, burdened with infectious diseases like HIV, TB, and malaria as well as broad genetic variation, it has become crucial to investigate drug-gene interactions as potential risk factors for treatment failure. There is also lack of clinical pharmacogenetics studies to evaluate the role of known genetic variants observed in treatment outcomes like ADRs, and drug resistance (Dandara et al., 2019). There is, therefore, a need for prospective studies to determine whether pretreatment genotyping can improve therapy especially in areas where there is the surge of infectious diseases.  This urges governments to invest in financing science studies like this, which can guide medical decisions and enhance medical treatment.

SANTHE is an Africa Health Research Institute (AHRI) flagship programme funded by the Science for Africa Foundation through the DELTAS Africa programme; the Bill & Melinda Gates Foundation; Gilead Sciences Inc.; and the Ragon Institute of Mass General, MIT, and Harvard.