Trends in HIV-1 pretreatment drug resistance and HIV-1 variant dynamics among antiretroviral therapy-naive Ethiopians from 2003 to 2018: a pooled sequence analysis
Abstract Background Ethiopia is among the highly HIV-affected countries, with reported 12,000 and 12,000 AIDS-related deaths and incidents as per reports from 2021. Although the country has made a promising progress in antiretroviral therapy, recent studies have indicated that pretreatment drug resi...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-10-01
|
| Series: | Virology Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12985-023-02205-w |
| _version_ | 1797350133059289088 |
|---|---|
| author | Mulugeta Kiros Sirak Biset Birhane Gebremariam Gebrehiwet Tesfay Yalew Woldaregay Erku Abegaz Alene Geteneh |
| author_facet | Mulugeta Kiros Sirak Biset Birhane Gebremariam Gebrehiwet Tesfay Yalew Woldaregay Erku Abegaz Alene Geteneh |
| author_sort | Mulugeta Kiros |
| collection | DOAJ |
| description | Abstract Background Ethiopia is among the highly HIV-affected countries, with reported 12,000 and 12,000 AIDS-related deaths and incidents as per reports from 2021. Although the country has made a promising progress in antiretroviral therapy, recent studies have indicated that pretreatment drug resistance (PDR) is alarmingly increasing, which has become a challenge for the effectiveness of HIV treatment. Epidemiologic data on PDR is necessary to help establish ART regimens with good efficacy. Thus, this systematic review aimed to determine the trend analysis of PDR among ART-naïve individuals along with HIV variant dynamics in Ethiopia. Method HIV-1 pol sequences from studies conducted between 2003 and 2018 among ART-naïve Ethiopian individuals were retrieved from GenBank and analyzed for the presence of PDR mutations (PDRM) along with the analysis of HIV-1 variant dynamics. The Calibrated Population Resistance (CPR) tool Version 8.1 and the REGA HIV-1 Subtyping Tool Version 3 were used to determine the PDRM and HIV-1 genetic diversity, respectively. Result We identified nine studies and analyzed 1070 retrieved HIV-1 pol sequences in this systematic review. The pooled prevalence of PDR was 4.8% (51/1070), including 1.4% (15/1070), 2.8% (30/1070), and 0.8% (9/1070) for nucleoside reverse transcriptase inhibitor (NRTI), non-NRTI (NNRTI), and protease inhibitor (PI) resistance, respectively. NRTI and NNRTI concurrent PDRM were observed among 0.2% (2/799) of the analyzed sequences. The overall PDR prevalence has been increasing over the years. Though the prevalence of the NNRTI, NRTI, and PI PDR also increased over the years, the NNRTI increment was more pronounced than the others, reaching 7.84% in 2018 from 2.19% in 2003. The majority (97%; 1038/1070) of the genetic diversity was HIV-1 subtype C virus, followed by subtype C’ (2%; 20/1038) and other subtypes (1%; 10/1038). Conclusions According to this systematic review, the overall pooled prevalence of PDR is low. Despite the low prevalence, there has been an increasing trend of PDR over the years, which implies the need for routine surveillance of PDRMs along with preventive measures. Hence, this supports the recently endorsed transition of ART regimens from NNRTI to integrase strand transfer inhibitor-based regimens recommended by the WHO. In addition, this finding underscores the need for routine baseline genotypic drug resistance testing for all newly diagnosed HIV-infected patients before initiating treatment to halt the upward trend of PDR. |
| first_indexed | 2024-03-08T12:40:22Z |
| format | Article |
| id | doaj.art-66721a869f6c43dda55cec544aeaca08 |
| institution | Directory Open Access Journal |
| issn | 1743-422X |
| language | English |
| last_indexed | 2024-03-08T12:40:22Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Virology Journal |
| spelling | doaj.art-66721a869f6c43dda55cec544aeaca082024-01-21T12:10:32ZengBMCVirology Journal1743-422X2023-10-0120111010.1186/s12985-023-02205-wTrends in HIV-1 pretreatment drug resistance and HIV-1 variant dynamics among antiretroviral therapy-naive Ethiopians from 2003 to 2018: a pooled sequence analysisMulugeta Kiros0Sirak Biset1Birhane Gebremariam2Gebrehiwet Tesfay Yalew3Woldaregay Erku Abegaz4Alene Geteneh5Department of Medical Laboratory Science, CollegeofMedicineandHealth Sciences, Aksum UniversityDepartment of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of GondarDepartment of Medical Laboratory Science, CollegeofMedicineandHealth Sciences, Aksum UniversityDepartment of Medical Laboratory Science, College of Medicine and Health Sciences, Adigrat UniversityDepartment of Microbiology, Parasitology, and Immunology, School of Medicine, Addis Ababa UniversityDepartment of Medical Laboratory Sciences, College of Health Sciences, Woldia UniversityAbstract Background Ethiopia is among the highly HIV-affected countries, with reported 12,000 and 12,000 AIDS-related deaths and incidents as per reports from 2021. Although the country has made a promising progress in antiretroviral therapy, recent studies have indicated that pretreatment drug resistance (PDR) is alarmingly increasing, which has become a challenge for the effectiveness of HIV treatment. Epidemiologic data on PDR is necessary to help establish ART regimens with good efficacy. Thus, this systematic review aimed to determine the trend analysis of PDR among ART-naïve individuals along with HIV variant dynamics in Ethiopia. Method HIV-1 pol sequences from studies conducted between 2003 and 2018 among ART-naïve Ethiopian individuals were retrieved from GenBank and analyzed for the presence of PDR mutations (PDRM) along with the analysis of HIV-1 variant dynamics. The Calibrated Population Resistance (CPR) tool Version 8.1 and the REGA HIV-1 Subtyping Tool Version 3 were used to determine the PDRM and HIV-1 genetic diversity, respectively. Result We identified nine studies and analyzed 1070 retrieved HIV-1 pol sequences in this systematic review. The pooled prevalence of PDR was 4.8% (51/1070), including 1.4% (15/1070), 2.8% (30/1070), and 0.8% (9/1070) for nucleoside reverse transcriptase inhibitor (NRTI), non-NRTI (NNRTI), and protease inhibitor (PI) resistance, respectively. NRTI and NNRTI concurrent PDRM were observed among 0.2% (2/799) of the analyzed sequences. The overall PDR prevalence has been increasing over the years. Though the prevalence of the NNRTI, NRTI, and PI PDR also increased over the years, the NNRTI increment was more pronounced than the others, reaching 7.84% in 2018 from 2.19% in 2003. The majority (97%; 1038/1070) of the genetic diversity was HIV-1 subtype C virus, followed by subtype C’ (2%; 20/1038) and other subtypes (1%; 10/1038). Conclusions According to this systematic review, the overall pooled prevalence of PDR is low. Despite the low prevalence, there has been an increasing trend of PDR over the years, which implies the need for routine surveillance of PDRMs along with preventive measures. Hence, this supports the recently endorsed transition of ART regimens from NNRTI to integrase strand transfer inhibitor-based regimens recommended by the WHO. In addition, this finding underscores the need for routine baseline genotypic drug resistance testing for all newly diagnosed HIV-infected patients before initiating treatment to halt the upward trend of PDR.https://doi.org/10.1186/s12985-023-02205-wHIVGenetic diversityDrug resistanceART-naiveAntiretroviral therapyPooled sequence analysis |
| spellingShingle | Mulugeta Kiros Sirak Biset Birhane Gebremariam Gebrehiwet Tesfay Yalew Woldaregay Erku Abegaz Alene Geteneh Trends in HIV-1 pretreatment drug resistance and HIV-1 variant dynamics among antiretroviral therapy-naive Ethiopians from 2003 to 2018: a pooled sequence analysis Virology Journal HIV Genetic diversity Drug resistance ART-naive Antiretroviral therapy Pooled sequence analysis |
| title | Trends in HIV-1 pretreatment drug resistance and HIV-1 variant dynamics among antiretroviral therapy-naive Ethiopians from 2003 to 2018: a pooled sequence analysis |
| title_full | Trends in HIV-1 pretreatment drug resistance and HIV-1 variant dynamics among antiretroviral therapy-naive Ethiopians from 2003 to 2018: a pooled sequence analysis |
| title_fullStr | Trends in HIV-1 pretreatment drug resistance and HIV-1 variant dynamics among antiretroviral therapy-naive Ethiopians from 2003 to 2018: a pooled sequence analysis |
| title_full_unstemmed | Trends in HIV-1 pretreatment drug resistance and HIV-1 variant dynamics among antiretroviral therapy-naive Ethiopians from 2003 to 2018: a pooled sequence analysis |
| title_short | Trends in HIV-1 pretreatment drug resistance and HIV-1 variant dynamics among antiretroviral therapy-naive Ethiopians from 2003 to 2018: a pooled sequence analysis |
| title_sort | trends in hiv 1 pretreatment drug resistance and hiv 1 variant dynamics among antiretroviral therapy naive ethiopians from 2003 to 2018 a pooled sequence analysis |
| topic | HIV Genetic diversity Drug resistance ART-naive Antiretroviral therapy Pooled sequence analysis |
| url | https://doi.org/10.1186/s12985-023-02205-w |
| work_keys_str_mv | AT mulugetakiros trendsinhiv1pretreatmentdrugresistanceandhiv1variantdynamicsamongantiretroviraltherapynaiveethiopiansfrom2003to2018apooledsequenceanalysis AT sirakbiset trendsinhiv1pretreatmentdrugresistanceandhiv1variantdynamicsamongantiretroviraltherapynaiveethiopiansfrom2003to2018apooledsequenceanalysis AT birhanegebremariam trendsinhiv1pretreatmentdrugresistanceandhiv1variantdynamicsamongantiretroviraltherapynaiveethiopiansfrom2003to2018apooledsequenceanalysis AT gebrehiwettesfayyalew trendsinhiv1pretreatmentdrugresistanceandhiv1variantdynamicsamongantiretroviraltherapynaiveethiopiansfrom2003to2018apooledsequenceanalysis AT woldaregayerkuabegaz trendsinhiv1pretreatmentdrugresistanceandhiv1variantdynamicsamongantiretroviraltherapynaiveethiopiansfrom2003to2018apooledsequenceanalysis AT alenegeteneh trendsinhiv1pretreatmentdrugresistanceandhiv1variantdynamicsamongantiretroviraltherapynaiveethiopiansfrom2003to2018apooledsequenceanalysis |