Your browser doesn't support javascript.
loading
Pretreatment HIV Drug Resistance Among Adults Initiating or Re-Initiating First-Line Antiretroviral Therapy in Zimbabwe: Fast-Tracking the Transition to Dolutegravir-Based First-Line Regimens?
Kouamou, Vinie; Mavetera, Justice; Manasa, Justen; Ndhlovu, Chiratidzo Ellen; Katzenstein, David; McGregor, Alan Michael.
Afiliación
  • Kouamou V; Department of Medicine and College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
  • Mavetera J; Department of Medicine and College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
  • Manasa J; Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
  • Ndhlovu CE; Department of Medicine and College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
  • Katzenstein D; Department of Molecular Biology, Biomedical Research and Training Institute, Harare, Zimbabwe.
  • McGregor AM; Department of Medicine and College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Artículo en Inglés | MEDLINE | ID: mdl-33430681
ABSTRACT
Pretreatment drug resistance (PDR) can compromise antiretroviral therapy (ART) efficacy and undermine the WHO targets to end the AIDS epidemic as a public health threat by 2030. Thus, we examined the level of PDR in Harare, Zimbabwe. Eligible study participants were adults who were ART naive or individuals with previous ART exposure reinitiating treatment, recruited between October 2018 and February 2020 in a HIV ART treatment clinic, in Harare. HIV drug resistance tests were performed for all specimens with viral load ≥400 copies/mL and interpreted using the Stanford HIVDB Algorithm. Chi-square test or Fisher's exact test was used for comparison of proportions of PDR across ART-naive or prior ART-exposed participants. All statistical analyses were performed using Stata version 14. Overall, 120 samples were genotyped of whom 104 were ART naive and 16 reported previous ART exposure. The overall PDR frequency among all participants was 31% [95% confidence interval (CI) 22.5-39.6]. PDR to any non-nucleotide reverse transcriptase inhibitor (NNRTI) was reported in 29% (95% CI 21.0-37.9). PDR to nucleotide reverse transcriptase inhibitors (NRTIs) and protease inhibitors were low, found in 3% (95% CI 0.9-8.2) and 1% (95% CI 0.02-4.52), respectively. PDR to NNRTIs [efavirenz/nevirapine (EFV/NVP)] was found in 17% (95% CI 10.5-24.6) and was more than six times higher among people with previous ART exposure than ART-naive people 63% versus 10%, p < .001. Our study shows that PDR to NNRTIs in Zimbabwe has remarkably increased from the 10.9% prevalence reported in the 2016 WHO survey. Addressing PDR at a national level is a critical need and will be facilitated by fast-tracking the transition to dolutegravir in first-line ART regimens.
Texto completo: Disponible Colección: Bases de datos internacionales Contexto en salud: Agenda de Salud Sostenible para las Américas Tema en salud: Objetivo 5: Medicamentos, vacunas y tecnologías sanitarias Base de datos: MEDLINE Tipo de estudio: Factores de riesgo Idioma: Inglés Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2021 Tipo del documento: Artículo País de afiliación: Zimbabwe

Similares

MEDLINE

...
LILACS

LIS

Texto completo: Disponible Colección: Bases de datos internacionales Contexto en salud: Agenda de Salud Sostenible para las Américas Tema en salud: Objetivo 5: Medicamentos, vacunas y tecnologías sanitarias Base de datos: MEDLINE Tipo de estudio: Factores de riesgo Idioma: Inglés Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2021 Tipo del documento: Artículo País de afiliación: Zimbabwe