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OBJECTIVE Evaluate the potential effectiveness of the implementation of DTG-based regimens in patients on failing current ART given the high levels of NRTI resistance in Togo. DESIGN Patients on ART attending health facilities for routine follow-up visits and for whom HIV viral load (VL) test was performed were consecutively included. METHODS Protease, Reverse Transcriptase (RT) and Integrase fragments were sequenced and analyzed for presence of drug resistance mutations (DRMs) for patients with VL > 1,000 copies/mL. RESULTS Among 1,681 patients, 320 (19.04%) had VL > 1,000 copies/ml and 200 were tested for DRMs. RT gene was successfully sequenced for 181/200 (90.5%) patients; 140/181 (77.4%) were resistant to NRTIs and NNRTIs, 4/181 (2.2%) to NRTIs only and 18/181 (9.9%) to NNRTIs only. Many viral strains accumulated mutations predicting resistance to NRTIs recommended in first and second line DTG-based ART regimens. ART switch to a DTG-based regimen after viral load testing (VL > 1,000 copies/ml) or blind switch without prior VL testing to a new DTG-based first line, estimated 31% and 47.6% of patients to be potentially on functional DTG monotherapy respectively. CONCLUSIONS Overall, our results predict that at the scale of sub-Saharan Africa a significant proportion of patients could be on functional monotherapy. In order to achieve the third 90 of UNAIDS objectives, implementation of DTG-based regimens should be accompanied with an accelerated scaling up of access to viral load. Studies designed to quantify the implications of use of suboptimal DTG-based regimens are also needed.