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dolutegravir dtg based antiretroviral therapy art largely replaced efavirenz efv based therapy preferred firstline regimen treatment adults hiv study carried evaluate comparative costeffectiveness dtg efvbased art hivinfected treatmentnave patients treatment centre nigeria retrospective casecontrol study patients initiated dtg vs efvbased regimens january 2018 december 2019 apinhavard clinic nigerias jos university teaching hospital current viral load result used determine treatment effectiveness using benchmark 200 copiesml sensitivity analysis carried ensure robustness benchmark total cost treatment obtained summing relevant cost components appropriate descriptive inferential statistics employed data analysis using statistical product services solutions spss v25 incremental costeffectiveness ratio dtg compared efv presented costeffectiveness treatment effective 42519 58716 patients initiated dtg efvbased regimen respectively incremental costeffective ratio icer patients dtg compared efv 105076 per effectiveness less 1 nigerian 2019 per capita gross domestic product sensitivity analysis showed robustness result efavirenz based regimen higher treatment effectiveness dtgbased regimen treatmentnaive patients initiating treatment short term compared efv dtgbased regimen costeffective management treatment nave hiv patients