Pre-treatment HIV-1 drug resistance in antiretroviral therapy-naive adults in Eastern Africa: a systematic review and meta-analysis.
J Antimicrob Chemother
; 77(12): 3231-3241, 2022 11 28.
Article
em En
| MEDLINE
| ID: mdl-36225089
ABSTRACT
BACKGROUND:
Pre-treatment HIV drug resistance (PDR) may result in increased risk of virological failure and acquisition of new resistance mutations. With recently increasing ART coverage and periodic modifications of the guidelines for HIV treatment, there is a need for an updated systematic review to assess the levels of the PDR among adults newly initiating ART in Eastern Africa.METHODS:
We conducted a systematic search for studies published between 1 January 2017 and 30 April 2022 in the MEDLINE Complete and CINAHL Complete, searched simultaneously using EBSCOhost, and Web of Science. To determine the overall PDR prevalence estimates, we extracted data from eligible articles and analysed prevalence estimates using Stata 14.2.RESULTS:
A total of 22 eligible observation studies were selected. The studies included a total of 5852 ART-naive people living with HIV. The overall pooled prevalence of PDR was 10.0% (95% CI 7.9%-12.0%, I2â=â88.9%) and 9.4% (95% CI 7.0%-11.9%, I2â=â90.4%) for NNRTIs, 2.6% (95% CI 1.8%-3.4%, I2â=â69.2%) for NRTIs and 0.7% (95% CI 0.3%-1.2%, I2â=â29.0%) for PIs. No major integrase strand transfer inhibitors (INSTI)-related mutations were identified.CONCLUSIONS:
We observed a moderate overall PDR prevalence among new ART initiators in this study. PDR to NNRTIs is more prevalent, underscoring the importance of the current WHO recommendation for replacement of NNRTIs by INSTIs. PDR to NRTIs was low but notable, which warrants continuous surveillance of pre-existing resistance to the dolutegravir co-administered NRTI in Eastern Africa.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
HIV-1
/
Soropositividade para HIV
/
Fármacos Anti-HIV
Tipo de estudo:
Guideline
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Adult
/
Humans
Idioma:
En
Revista:
J Antimicrob Chemother
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Tanzânia