This study describes the transition to DTG and examines the effect of TB and AHD (CD4 count < 200 cells/mm<sup>3</sup>) on the likelihood of transitioning to DTG in rural KZN, South Africa.<h4>Methods</h4>We conducted a longitudinal cohort analysis using routine HIV program data from 69,916 PLHIV aged ≥ 15 years attending 19 HIV clinics in rural KZN, between 1st October 2019, and December 31st 2023. The gene discussed is CD4; the disease is tuberculosis.