Antiretroviral resistance among HIV-1 patients on first-line therapy attending a comprehensive care clinic in Kenyatta National Hospital, Kenya: a retrospective analysis

Kinyua, Joyceline; Lihana, Raphael; Kiptoo, Michael; Muasya, T; Odera, Irene; Muiruri, Patrick; Songok, Elijah

doi:10.11604/pamj.2018.29.186.10796

Cited by 7 publications

(8 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The current study recorded a higher prevalence of HIV-1 drug-resistance compared to prevalence recorded in the previous studies [ 6 , 7 , 15 , 22 ], by a bigger margin. This implies that the problem of the drug-resistance will continue to rise until additional measures are put in the place.…”

Section: Discussioncontrasting

confidence: 57%

“…PI major mutations were identified with I54V, F53L, V82A being prevalent. Some of these mutations have been identified in other similar studies in Kenya with K103N and M184V being predominant [ 7 , 11 , 15 , 25 , 26 ]. A scenario observed in the current study.…”

Section: Discussionmentioning

confidence: 87%

“…However, the combination regimens are also threatened by the development of mutations by the virus against them. Past studies have identified 13.8% among Kenyan injecting drug users, while another study identified a drug mutation prevalence of 23.1% among general adult population [ 6 , 7 ]. However, these studies were carried out prior to the World Health Organization guidelines that everyone infected with HIV to be initiated to drugs regardless of CD4 tally.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of human immunodeficiency virus-1 drug-resistant mutations among adults on first- and second-line antiretroviral therapy in a resource-limited health facility in Busia County, Kenya

Makwaga¹,

Adhiambo²,

Mulama³

et al. 2020

Pan Afr Med J

View full text Add to dashboard Cite

Introduction in Kenya, about 1.5 million people are living with the Human Immunodeficiency Virus (HIV). Antiretroviral therapy aids in viral suppression. However, drug-resistance threaten the gains of the HIV infection control program. To determine the prevalence of HIV-1 drug-resistant mutations among adults on ARV therapy attending Khunyangu sub-county hospital in Busia County, Kenya, 50 blood samples were analyzed. Methods the samples were collected from November 2019 to January 2020 and tested for HIV-1 viral load. HIV-1 drug-resistance was analyzed through the sequencing of the HIV-1 pol gene. Generated sequences were aligned using RECall (beta v3.05) software. HIV-1 drug-resistance was determined using the Stanford University HIV database. Results females were 34 and males 16. The general prevalence of HIV-1 drug-resistance was 68%. Out of 34 participants on first-line drugs, 59.9% had mutations against these drugs and 5.9% against the second-line drugs. Out of 16 participants on second-line drugs, 43.8% had mutations against these drugs and 50% against the first-line drugs. The prevalence of mutations encoding resistance to Nucleotide reverse transcriptase inhibitors (NRTIs) were 23(46%); Non-nucleotide Reverse transcriptase inhibitors (NNRTIs), 29(58%) and protease inhibitors (PIs), 7(14%). Dual and multi-class HIV-1 drug-resistance prevalence was as follows: NRTIs + NNRTIs 16(32%); NRTIs + NNRTs + PIs 4(8%); NRTIs + PIs 1(2%). A total of 126 mutations were identified. Predominant NNRTIs mutations were K103N (15), Y181C (9), G190A (7), and H221Y (6) NRTIs, M184V (17), Y115F (5) and PIs, I54V (4). Conclusion the study demonstrates a high prevalence of HIV-1 drug-resistance which calls for intervention for the strengthening of health programs.

show abstract

Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of human immunodeficiency virus-1 drug-resistant mutations among adults on first- and second-line antiretroviral therapy in a resource-limited health facility in Busia County, Kenya

Makwaga¹,

Adhiambo²,

Mulama³

et al. 2020

Pan Afr Med J

View full text Add to dashboard Cite

show abstract

“…HIV drug resistance may also contribute to VF in this group that had a higher prevalence of previous ART exposure. Drug resistance is increasing in sub-Saharan Africa [ 32 , 33 ]; thus, expanding drug resistance testing (including pre-ART screening) is important considering the historic use of NNRTI single agents for prevention of mother-to-child transmission, the anticipated rollout of tenofovir-based preexposure prophylaxis, and the transition to dolutegravir-based regimens [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Better Virological Outcomes Among People Living With Human Immunodeficiency Virus (HIV) Initiating Early Antiretroviral Treatment (CD4 Counts ≥500 Cells/µL) in the HIV Prevention Trials Network 071 (PopART) Trial in South Africa

Fatti

Grimwood

Nachega

et al. 2019

Clinical Infectious Diseases

View full text Add to dashboard Cite

Background There have been concerns about reduced adherence and human immunodeficiency virus (HIV) virological suppression (VS) among clinically well people initiating antiretroviral therapy (ART) with high pre-ART CD4 cell counts. We compared virological outcomes by pre-ART CD4 count, where universal ART initiation was provided in the HIV Prevention Trials Network 071 (PopART) trial in South Africa prior to routine national and international implementation. Methods This prospective cohort study included adults initiating ART at facilities providing universal ART since January 2014. VS (<400 copies/mL), confirmed virological failure (VF) (2 consecutive viral loads >1000 copies/mL), and viral rebound were compared between participants in strata of baseline CD4 cell count. Results The sample included 1901 participants. VS was ≥94% among participants with baseline CD4 count ≥500 cells/µL at all 6-month intervals to 30 months. The risk of an elevated viral load (≥400 copies/mL) was independently lower among participants with baseline CD4 count ≥500 cells/µL (3.3%) compared to those with CD4 count 200–499 cells/µL (9.2%) between months 18 and 30 (adjusted relative risk, 0.30 [95% confidence interval, .12–.74]; P = .010). The incidence rate of VF was 7.0, 2.0, and 0.5 per 100 person-years among participants with baseline CD4 count <200, 200–499, and ≥500 cells/µL, respectively (P < .0001). VF was independently lower among participants with baseline CD4 count ≥500 cells/µL (adjusted hazard ratio [aHR], 0.23; P = .045) and 3-fold higher among those with baseline CD4 count <200 cells/µL (aHR, 3.49; P < .0001). Conclusions Despite previous concerns, participants initiating ART with CD4 counts ≥500 cells/µL had very good virological outcomes, being better than those with CD4 counts 200–499 cells/µL. Clinical Trials Registration NCT01900977.

show abstract

“…The most frequently identifi ed mutations were M184V, K65R, and TAMs, also, two-class resistance was detected in 84% (62/74) of the participants owed to NRTIs and NNRTIs. In Kenya, the prevalence of drug resistance was reported to be 23.1% among the studied population with M184V and K103N been the most prevalent drug mutations [45]. Overall, Zimbabwe had the highest prevalence of HIV drug resistance.…”

Section: Prevalence Of Hiv Drug Resistancementioning

confidence: 87%

Human Immunodeficiency Virus (HIV) Drug Resistance: A Global Narrative Review

Phiri¹,

Mudenda²

2021

J Biomed Res Environ Sci

View full text Add to dashboard Cite

Background: Antiretroviral Therapy (ART) has significantly improved Human Immunodeficiency Virus (HIV) patients’ survival rates. However, the emergence of HIV Drug Resistance (HIVDR) has markedly reduced the effectiveness of Antiretroviral Therapy (ART). Aim: This narrative review was conducted to review published studies on HIV drug resistance and its consequences. Materials and methods: A literature search for this narrative review was carried out and the following databases were used PubMed, Google Scholar, and The Lancet. The cited articles were published from 1999 to 2021. The keywords used in the search of literature included ‘Antiretroviral therapy’, ‘resistance’, and ‘Human Immunodeficiency Virus drug resistance’, ‘HIV’, ‘HIV drug resistance’, ‘HIV vaccines’, and the Boolean word ‘AND’. Results: There is a high prevalence of HIV drug resistance globally that has been associated with some factors such as older age, non-adherence to treatment, long treatment duration, lower cell count and high viral load. HIV drug resistance may lead to treatment failure, prolongation of the time required to achieve viral suppression and leads to increased mortality. Increasing access to viral load monitoring can help mitigate HIV drug resistance. Conclusion: HIV drug resistance is a global threat to public health and has been associated with increased morbidity and mortality. Therefore, there is a need for more research to be carried out and various strategies like the use of antiretrovirals with a high genetic barrier to resistance need to be put in place to prevent further spread resistance. HIVDR must be monitored frequently taking into consideration the geographic variability. There is an urgent need for the development of anti-HIV vaccines that will help to prevent further transmission and spread of HIV.

show abstract

Antiretroviral resistance among HIV-1 patients on first-line therapy attending a comprehensive care clinic in Kenyatta National Hospital, Kenya: a retrospective analysis

Cited by 7 publications

References 16 publications

Prevalence of human immunodeficiency virus-1 drug-resistant mutations among adults on first- and second-line antiretroviral therapy in a resource-limited health facility in Busia County, Kenya

Prevalence of human immunodeficiency virus-1 drug-resistant mutations among adults on first- and second-line antiretroviral therapy in a resource-limited health facility in Busia County, Kenya

Better Virological Outcomes Among People Living With Human Immunodeficiency Virus (HIV) Initiating Early Antiretroviral Treatment (CD4 Counts ≥500 Cells/µL) in the HIV Prevention Trials Network 071 (PopART) Trial in South Africa

Human Immunodeficiency Virus (HIV) Drug Resistance: A Global Narrative Review

Contact Info

Product

Resources

About