Virological failure rates and HIV-1 drug resistance patterns in patients on first-line antiretroviral treatment in semirural and rural Gabon
Florian Liegeois,Caroline Vella,Sabrina Eymard-Duvernay,Jeanne Sica,Laurent Makosso,Augustin Mouinga-Ondémé,Arnaud Delis Mongo,Vanina Boué,Christelle Butel,Martine Peeters,Jean-Paul Gonzalez,Eric Delaporte,François Rouet +12 more
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As antiretroviral treatment (ART) continues to expand in resource‐limited countries, the emergence of HIV drug resistance mutations (DRMs) is challenging in these settings.Abstract:
Introduction: As antiretroviral treatment (ART) continues to expand in resource-limited countries, the emergence of HIV drug resistance mutations (DRMs) is challenging in these settings. In Gabon (central Africa), no study has yet reported the virological effectiveness of initial ART given through routine HIV care. Methods: Following the World Health Organization (WHO) recommendations, a cross-sectional study with a one-time HIV-1 RNA viral load (VL) measurement was conducted in Gabon to assess virological failure (VF) defined by a VL result ≥1000 copies/ml and DRMs among adult patients living with non-B HIV-1 strains and receiving first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy for at least 12 months. Risk factors associated with VF and DRMs were assessed. Results: Between March 2010 and March 2011, a total of 375 patients were consecutively enrolled from two decentralized (one semirural and one rural) HIV care centres. Median time on ART was 33.6 months (range, 12-107). Overall, the rate of VF was 41.3% (36.4-46.4). Among viremic patients, 56.7% (80/141) had at least one DRM and 37.6% had dual-class resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and NNRTIs. The most frequent DRMs were K103N/S (46.1%) and M184V/I (37.6%). Thymidine analogue mutations were found in 10.6%. Independent risk factors associated with VF were being followed up at the semirural centre ( P =0.033), having experienced unstructured treatment interruptions ( P =0.0044), and having low CD4 counts at enrolment ( P <0.0001). A longer time on ART ( P =0.0008) and being followed up at the rural centre ( P =0.021) were risk factors for DRMs. Conclusions: This is the first study conducted in Gabon providing VF rates and DRM patterns in adult patients receiving first-line ART. In sub-Saharan Africa, where NNRTI-based regimens are recommended as the standard for first-line ART, strengthening virological monitoring together with preventing unplanned treatment interruptions are a global public health priority. Keywords: HIV; Africa; antiretroviral therapy; viral load; resistance. (Published: 28 November 2012) Citation: Liegeois F et al. Journal of the International AIDS Society 2012, 15 :17985 http://www.jiasociety.org/index.php/jias/article/view/17985 | http://dx.doi.org/10.7448/IAS.15.2.17985read more
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HIV drug resistance and hepatitis co-infections in HIV-infected adults and children initiating antiretroviral therapy in Rwanda
TL;DR: The limitation of clinico-immunological criteria to detect virological failure are confirmed, highlighting the need for better access to viral load testing to reduce acquired HIVDR and treatment outcomes among children are less favorable than among adults, suggesting needed adjustment of pediatric HIV care.
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Determinants of therapy failure among adults on first-line antiretroviral therapy in Asmara, Eritrea: a multicenter retrospective matched case–control study
Samuel Mengistu,Ghirmay Ghebrekidan Ghebremeskel,Hermon Berhe Ghebrat,Oliver Okoth Achila,Nahom Yohannes,Amon Solomon Ghebrenegus,Filmon Ghebretsadik Wendmhuney,Naod Yeibyo,Amanuel Kidane Andegiorgish,A. B. Mesfin,Negassi Leake +10 more
TL;DR: In this paper , a multicenter, retrospective 1:2 matched (by age and gender) case-control study was conducted in four major hospitals in Asmara, Eritrea on adults aged ≥ 18 years who were on treatment for at least 6 months.
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Human T-Cell Leukemia Virus Type 1-Related Diseases May Constitute a Threat to the Elimination of Human Immunodeficiency Virus, by 2030, in Gabon, Central Africa
Eldridge Fedricksen Oloumbou,Jéordy-Dimitri Engone-Ondo,Issakou Mamimandjiami Idam,Pamela Moussavou-Boudzanga,Ivan Mfouo-Tynga,Augustin Mouinga-Ondémé +5 more
TL;DR: In this article , the negative impacts of HTLV-1/HIV-1 co-infections and related factors on the elimination of HIV/AIDS by 2030 in Gabon were assessed.
Journal ArticleDOI
Determinants of virological failure among patients on first line highly active antiretroviral therapy (HAART) in Southwest Ethiopia: A case-control study
Biruk Bogale,Adane Asefa,Alemnew Destaw,Gachana Midaksa,Zufan Asaye,Mathewos Alemu Gebremichael,Asrat Wolde,Ejig Yimer,Tewodros Yosef +8 more
TL;DR: It was revealed that the sex of the patient, history of substance use, baseline Hgb < 12 mg/dl, poor drug adherence, restart after an interruption, and having OI through the follow-up period were determinants of virological failure.
Dissertation
Detection of MegaTAL-induced HIV pol Mutation By Droplet Digital PCR
TL;DR: Detection of MegaTAL-induced HIV pol Mutation By Droplet Digital PCR by Droplets Digital PCR is reported.
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Mina C. Hosseinipour,Joep J. van Oosterhout,Ralf Weigel,Sam Phiri,Debbie Kamwendo,Neil Parkin,Susan A. Fiscus,Julie A. E. Nelson,Joseph J. Eron,Johnstone Kumwenda +9 more
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