HIV virologic response, patterns of drug resistance mutations and correlates among adolescents and young adults: A cross-sectional study in Tanzania.
<h4>Background</h4>The emergence of HIV drug resistance mutations (DRMs) is of significant threat to achieving viral suppression (VS) in the quest to achieve global elimination targets. We hereby report virologic outcomes and patterns of acquired DRMs and its associated factors among ado...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0281528 |
| _version_ | 1811162618803519488 |
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| author | Joan Rugemalila Doreen Kamori Peter Kunambi Mucho Mizinduko Amon Sabasaba Salim Masoud Frank Msafiri Sabina Mugusi Rita Mutagonda Linda Mlunde Davis Amani Erick Mboya Macdonald Mahiti George Ruhago Jeremiah Mushi Veryeh Sambu George Mgomella Boniface Jullu Werner Maokola Prosper Njau Beatrice Mutayoba Godfrey Barabona Takamasa Ueno Andrea Pembe Tumaini Nagu Bruno Sunguya Said Aboud |
| author_facet | Joan Rugemalila Doreen Kamori Peter Kunambi Mucho Mizinduko Amon Sabasaba Salim Masoud Frank Msafiri Sabina Mugusi Rita Mutagonda Linda Mlunde Davis Amani Erick Mboya Macdonald Mahiti George Ruhago Jeremiah Mushi Veryeh Sambu George Mgomella Boniface Jullu Werner Maokola Prosper Njau Beatrice Mutayoba Godfrey Barabona Takamasa Ueno Andrea Pembe Tumaini Nagu Bruno Sunguya Said Aboud |
| author_sort | Joan Rugemalila |
| collection | DOAJ |
| description | <h4>Background</h4>The emergence of HIV drug resistance mutations (DRMs) is of significant threat to achieving viral suppression (VS) in the quest to achieve global elimination targets. We hereby report virologic outcomes and patterns of acquired DRMs and its associated factors among adolescents and young adults (AYA) from a broader HIV drug resistance surveillance conducted in Tanzania.<h4>Methods</h4>Data of AYA was extracted from a cross-sectional study conducted in 36 selected facilities using a two-stage cluster sampling design. Dried blood spot (DBS) samples were collected and samples with a viral load (VL) ≥1000 copies/mL underwent genotyping for the HIV-1 pol gene. Stanford HIV database algorithm predicted acquired DRMs, Fisher's exact test and multivariable logistic regression assessed factors associated with DRMs and VS, respectively.<h4>Findings</h4>We analyzed data of 578 AYA on antiretroviral therapy (ART) for 9-15 and ≥ 36 months; among them, 91.5% and 88.2% had VS (VL<1000copies/mL) at early and late time points, respectively. Genotyping of 64 participants (11.2%) who had VL ≥1000 copies/ml detected 71.9% of any DRM. Clinically relevant DRMs were K103N, M184V, M41L, T215Y/F, L210W/L, K70R, D67N, L89V/T, G118R, E138K, T66A, T97A and unexpectedly absent K65R. Participants on a protease inhibitor (PI) based regimen were twice as likely to not achieve VS compared to those on integrase strand transfer inhibitors (INSTI). The initial VL done 6 months after ART initiation of ≥1000copies/mL was the primary factor associated with detecting DRMs (p = .019).<h4>Conclusions</h4>VS amongst AYA is lower than the third UNAIDs target. Additionally, a high prevalence of ADR and high levels of circulating clinically relevant DRMs may compromise the long-term VS in AYA. Furthermore, the first VL result of ≥1000copies/ml after ART initiation is a significant risk factor for developing DRMs. Thus, strict VL monitoring for early identification of treatment failure and genotypic testing during any ART switch is recommended to improve treatment outcomes for AYA. |
| first_indexed | 2024-04-10T06:33:23Z |
| format | Article |
| id | doaj.art-cd2c88ae06cd488ab61f184f23d48941 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-10T06:33:23Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-cd2c88ae06cd488ab61f184f23d489412023-03-01T05:31:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01182e028152810.1371/journal.pone.0281528HIV virologic response, patterns of drug resistance mutations and correlates among adolescents and young adults: A cross-sectional study in Tanzania.Joan RugemalilaDoreen KamoriPeter KunambiMucho MizindukoAmon SabasabaSalim MasoudFrank MsafiriSabina MugusiRita MutagondaLinda MlundeDavis AmaniErick MboyaMacdonald MahitiGeorge RuhagoJeremiah MushiVeryeh SambuGeorge MgomellaBoniface JulluWerner MaokolaProsper NjauBeatrice MutayobaGodfrey BarabonaTakamasa UenoAndrea PembeTumaini NaguBruno SunguyaSaid Aboud<h4>Background</h4>The emergence of HIV drug resistance mutations (DRMs) is of significant threat to achieving viral suppression (VS) in the quest to achieve global elimination targets. We hereby report virologic outcomes and patterns of acquired DRMs and its associated factors among adolescents and young adults (AYA) from a broader HIV drug resistance surveillance conducted in Tanzania.<h4>Methods</h4>Data of AYA was extracted from a cross-sectional study conducted in 36 selected facilities using a two-stage cluster sampling design. Dried blood spot (DBS) samples were collected and samples with a viral load (VL) ≥1000 copies/mL underwent genotyping for the HIV-1 pol gene. Stanford HIV database algorithm predicted acquired DRMs, Fisher's exact test and multivariable logistic regression assessed factors associated with DRMs and VS, respectively.<h4>Findings</h4>We analyzed data of 578 AYA on antiretroviral therapy (ART) for 9-15 and ≥ 36 months; among them, 91.5% and 88.2% had VS (VL<1000copies/mL) at early and late time points, respectively. Genotyping of 64 participants (11.2%) who had VL ≥1000 copies/ml detected 71.9% of any DRM. Clinically relevant DRMs were K103N, M184V, M41L, T215Y/F, L210W/L, K70R, D67N, L89V/T, G118R, E138K, T66A, T97A and unexpectedly absent K65R. Participants on a protease inhibitor (PI) based regimen were twice as likely to not achieve VS compared to those on integrase strand transfer inhibitors (INSTI). The initial VL done 6 months after ART initiation of ≥1000copies/mL was the primary factor associated with detecting DRMs (p = .019).<h4>Conclusions</h4>VS amongst AYA is lower than the third UNAIDs target. Additionally, a high prevalence of ADR and high levels of circulating clinically relevant DRMs may compromise the long-term VS in AYA. Furthermore, the first VL result of ≥1000copies/ml after ART initiation is a significant risk factor for developing DRMs. Thus, strict VL monitoring for early identification of treatment failure and genotypic testing during any ART switch is recommended to improve treatment outcomes for AYA.https://doi.org/10.1371/journal.pone.0281528 |
| spellingShingle | Joan Rugemalila Doreen Kamori Peter Kunambi Mucho Mizinduko Amon Sabasaba Salim Masoud Frank Msafiri Sabina Mugusi Rita Mutagonda Linda Mlunde Davis Amani Erick Mboya Macdonald Mahiti George Ruhago Jeremiah Mushi Veryeh Sambu George Mgomella Boniface Jullu Werner Maokola Prosper Njau Beatrice Mutayoba Godfrey Barabona Takamasa Ueno Andrea Pembe Tumaini Nagu Bruno Sunguya Said Aboud HIV virologic response, patterns of drug resistance mutations and correlates among adolescents and young adults: A cross-sectional study in Tanzania. PLoS ONE |
| title | HIV virologic response, patterns of drug resistance mutations and correlates among adolescents and young adults: A cross-sectional study in Tanzania. |
| title_full | HIV virologic response, patterns of drug resistance mutations and correlates among adolescents and young adults: A cross-sectional study in Tanzania. |
| title_fullStr | HIV virologic response, patterns of drug resistance mutations and correlates among adolescents and young adults: A cross-sectional study in Tanzania. |
| title_full_unstemmed | HIV virologic response, patterns of drug resistance mutations and correlates among adolescents and young adults: A cross-sectional study in Tanzania. |
| title_short | HIV virologic response, patterns of drug resistance mutations and correlates among adolescents and young adults: A cross-sectional study in Tanzania. |
| title_sort | hiv virologic response patterns of drug resistance mutations and correlates among adolescents and young adults a cross sectional study in tanzania |
| url | https://doi.org/10.1371/journal.pone.0281528 |
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