HIV-1 drug resistance mutations among individuals with low-level viraemia while taking combination ART in Botswana.
J Antimicrob Chemother
; 77(5): 1385-1395, 2022 04 27.
Article
en En
| MEDLINE
| ID: mdl-35229102
ABSTRACT
OBJECTIVES:
To assess whether a single instance of low-level viraemia (LLV) is associated with the presence of drug resistance mutations (DRMs) and predicts subsequent virological failure (VF) in adults receiving ART in 30 communities participating in the Botswana Combination Prevention Project.METHODS:
A total of 6078 HIV-1 C pol sequences were generated and analysed using the Stanford HIV drug resistance database. LLV was defined as plasma VL = 51-999â copies/mL and VF was defined as plasma VL ≥ 1000â copies/mL.RESULTS:
Among 6078 people with HIV (PWH), 4443 (73%) were on ART for at least 6â months. Of the 332 persons on ART with VL > 50â copies/mL, 175 (4%) had VL ≥ 1000â copies/mL and 157 (4%) had LLV at baseline. The prevalence of any DRM was 57 (36%) and 78 (45%) in persons with LLV and VL ≥ 1000â copies/mL, respectively. Major DRMs were found in 31 (20%) with LLV and 53 (30%) with VL ≥ 1000â copies/mL (P = 0.04). Among the 135 PWH with at least one DRM, 17% had NRTI-, 35% NNRTI-, 6% PI- and 3% INSTI-associated mutations. Among the 3596 participants who were followed up, 1709 (48%) were on ART for ≥6â months at entry and had at least one subsequent VL measurement (median 29â months), 43 (3%) of whom had LLV. The OR of experiencing VF in persons with LLV at entry was 36-fold higher than in the virally suppressed group.CONCLUSIONS:
A single LLV measurement while on ART strongly predicted the risk of future VF, suggesting the use of VL > 50â copies/mL as an indication for more intensive adherence support with more frequent VL monitoring.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Infecciones por VIH
/
VIH-1
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Seropositividad para VIH
/
Fármacos Anti-VIH
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
País/Región como asunto:
Africa
Idioma:
En
Revista:
J Antimicrob Chemother
Año:
2022
Tipo del documento:
Article
País de afiliación:
Botswana