The SLR identified 249 publications reporting DTG + 3TC use for treatment of HIV in real-world settings (Fig. 1). These publications represent 191 studies, 84 discrete cohorts, and 44,436 unique individuals (naive to ART, n = 2346; prior ART, n = 20,060; unspecified/pooled, n = 22,030).

Systematic literature review PRISMA flowchart. DTG dolutegravir, PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses, RWE real-world evidence, 3TC lamivudine. aOther includes records not classified under key categories. bSearched congresses included the Asian Conference on Hepatitis and AIDS; Australasian HIV & AIDS Conference; British Association for Sexual Health and HIV; British HIV Association; Canadian Conference on HIV/AIDS Research; Conference on Retroviruses and Opportunistic Infections; European AIDS Clinical Society; Grupo de Estudio del SIDA-SEIMC; HIV & Hepatitis in the Americas; HIV Glasgow; IDWeek; International AIDS Society/International AIDS Conference; International Conference on AIDS and Sexually Transmitted Infections in Africa; International Conference on Antiviral Research; International Congress on Infectious Diseases; International Francophone Conference on HIV/Hepatitis/Sexual Health/Emerging Infections (AFRAVIH; searched May 24, 2022); Japanese Society for AIDS Research; Kenya Association of Physicians; National Conference of AIDS Society of India; Société Française de Lutte contre le Sida; and The HIV Netherlands Australia Thailand Research Collaboration

Among the 249 SLR-identified publications, 43 publications (n = 13,714 individuals) reported outcomes of interest at weeks 48 and/or 96 and were included in the meta-analysis (Fig. 1; Table S2) [21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63]. Outcome data from 15 lead studies with populations naive to ART (n = 1480 individuals) and 27 lead studies with populations with prior ART experience (n = 12,234 individuals) were used in meta-analysis calculations. Baseline characteristics of populations from studies included in the meta-analysis are summarized in Table 1 [21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63].

Among studies reporting baseline viral load categories for individuals naive to ART, approximately 32.6% (396/1214) of unique individuals had viral loads ≥ 100,000 copies/mL [21,22,23,24, 27, 29, 30, 32, 37, 38] and 24.1% (93/386) had viral loads ≥ 500,000 copies/mL [23, 24, 28, 31, 38]. Among studies reporting RAMs before DTG + 3TC initiation, 1.3% (12/916) of unique individuals had transmitted drug resistance at baseline; of them, 3 (< 1.0%) individuals had the 3TC RAM M184V and 3 (< 1.0%) had integrase strand transfer inhibitor (INSTI) RAMs (G163K, n = 1; unspecified, n = 2) [21, 24, 30, 32, 33, 36, 37].

Among studies reporting baseline viral load for individuals with prior ART experience, 2.6% (318/12,124) of unique individuals included in at least one meta-analysis calculation at week 48 [25, 33,34,35, 39,40,41,42,43,44,45,46,47,48, 50,51,52,53,54,55, 57,58,59,60,61,62,63] and 3.4% (174/5104) included at week 96 [22,