HIV virologic response, patterns of drug resistance mutations and correlates among adolescents and young adults: A cross-sectional study in Tanzania
The emergence of HIV drug resistance mutations (DRMs) is of significant threat to achieving viral suppression (VS) in the quest to achieve global elimination targets. We hereby report virologic outcomes and patterns of acquired DRMs and its associated factors among adolescents and young adults (AYA)...
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| Veröffentlicht in: | PloS one 2023-02, Vol.18 (2), p.e0281528-e0281528 |
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| creator | Rugemalila, Joan Kamori, Doreen Kunambi, Peter Mizinduko, Mucho Sabasaba, Amon Masoud, Salim Msafiri, Frank Mugusi, Sabina Mutagonda, Rita Mlunde, Linda Amani, Davis Mboya, Erick Mahiti, Macdonald Ruhago, George Mushi, Jeremiah Sambu, Veryeh Mgomella, George Jullu, Boniface Maokola, Werner Njau, Prosper Mutayoba, Beatrice Barabona, Godfrey Ueno, Takamasa Pembe, Andrea Nagu, Tumaini Sunguya, Bruno Aboud, Said |
| description | The emergence of HIV drug resistance mutations (DRMs) is of significant threat to achieving viral suppression (VS) in the quest to achieve global elimination targets. We hereby report virologic outcomes and patterns of acquired DRMs and its associated factors among adolescents and young adults (AYA) from a broader HIV drug resistance surveillance conducted in Tanzania.
Data of AYA was extracted from a cross-sectional study conducted in 36 selected facilities using a two-stage cluster sampling design. Dried blood spot (DBS) samples were collected and samples with a viral load (VL) ≥1000 copies/mL underwent genotyping for the HIV-1 pol gene. Stanford HIV database algorithm predicted acquired DRMs, Fisher's exact test and multivariable logistic regression assessed factors associated with DRMs and VS, respectively.
We analyzed data of 578 AYA on antiretroviral therapy (ART) for 9-15 and ≥ 36 months; among them, 91.5% and 88.2% had VS (VL |
| doi_str_mv | 10.1371/journal.pone.0281528 |
| format | Article |
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Data of AYA was extracted from a cross-sectional study conducted in 36 selected facilities using a two-stage cluster sampling design. Dried blood spot (DBS) samples were collected and samples with a viral load (VL) ≥1000 copies/mL underwent genotyping for the HIV-1 pol gene. Stanford HIV database algorithm predicted acquired DRMs, Fisher's exact test and multivariable logistic regression assessed factors associated with DRMs and VS, respectively.
We analyzed data of 578 AYA on antiretroviral therapy (ART) for 9-15 and ≥ 36 months; among them, 91.5% and 88.2% had VS (VL<1000copies/mL) at early and late time points, respectively. Genotyping of 64 participants (11.2%) who had VL ≥1000 copies/ml detected 71.9% of any DRM. Clinically relevant DRMs were K103N, M184V, M41L, T215Y/F, L210W/L, K70R, D67N, L89V/T, G118R, E138K, T66A, T97A and unexpectedly absent K65R. Participants on a protease inhibitor (PI) based regimen were twice as likely to not achieve VS compared to those on integrase strand transfer inhibitors (INSTI). The initial VL done 6 months after ART initiation of ≥1000copies/mL was the primary factor associated with detecting DRMs (p = .019).
VS amongst AYA is lower than the third UNAIDs target. Additionally, a high prevalence of ADR and high levels of circulating clinically relevant DRMs may compromise the long-term VS in AYA. Furthermore, the first VL result of ≥1000copies/ml after ART initiation is a significant risk factor for developing DRMs. Thus, strict VL monitoring for early identification of treatment failure and genotypic testing during any ART switch is recommended to improve treatment outcomes for AYA.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0281528</identifier><identifier>PMID: 36821538</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adolescents ; Adults ; Algorithms ; Anti-HIV Agents - pharmacology ; Anti-HIV Agents - therapeutic use ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Antiviral agents ; Biology and Life Sciences ; Cross-Sectional Studies ; Dosage and administration ; Drug resistance ; Drug Resistance, Viral - genetics ; Drug therapy ; Evaluation ; Genotype ; Genotyping ; Health aspects ; HIV ; HIV infection ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; Human immunodeficiency virus ; Humans ; Integrase ; Medicine and Health Sciences ; Mutation ; People and Places ; Pol gene ; Protease inhibitors ; Proteinase inhibitors ; Research and Analysis Methods ; Risk factors ; Sampling designs ; Tanzania - epidemiology ; Teenagers ; Viral Load ; Young Adult ; Young adults ; Youth</subject><ispartof>PloS one, 2023-02, Vol.18 (2), p.e0281528-e0281528</ispartof><rights>Copyright: © 2023 Rugemalila et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Rugemalila et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Rugemalila et al 2023 Rugemalila et al</rights><rights>2023 Rugemalila et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-41305ae152df5781e440daf3492262a95fbc64396be51372dc713f16a71c1c8d3</citedby><cites>FETCH-LOGICAL-c758t-41305ae152df5781e440daf3492262a95fbc64396be51372dc713f16a71c1c8d3</cites><orcidid>0000-0001-6939-5125 ; 0000-0003-0563-8188 ; 0000-0003-4852-4236 ; 0000-0002-8090-3298</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949668/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949668/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36821538$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rugemalila, Joan</creatorcontrib><creatorcontrib>Kamori, Doreen</creatorcontrib><creatorcontrib>Kunambi, Peter</creatorcontrib><creatorcontrib>Mizinduko, Mucho</creatorcontrib><creatorcontrib>Sabasaba, Amon</creatorcontrib><creatorcontrib>Masoud, Salim</creatorcontrib><creatorcontrib>Msafiri, Frank</creatorcontrib><creatorcontrib>Mugusi, Sabina</creatorcontrib><creatorcontrib>Mutagonda, Rita</creatorcontrib><creatorcontrib>Mlunde, Linda</creatorcontrib><creatorcontrib>Amani, Davis</creatorcontrib><creatorcontrib>Mboya, Erick</creatorcontrib><creatorcontrib>Mahiti, Macdonald</creatorcontrib><creatorcontrib>Ruhago, George</creatorcontrib><creatorcontrib>Mushi, Jeremiah</creatorcontrib><creatorcontrib>Sambu, Veryeh</creatorcontrib><creatorcontrib>Mgomella, George</creatorcontrib><creatorcontrib>Jullu, Boniface</creatorcontrib><creatorcontrib>Maokola, Werner</creatorcontrib><creatorcontrib>Njau, Prosper</creatorcontrib><creatorcontrib>Mutayoba, Beatrice</creatorcontrib><creatorcontrib>Barabona, Godfrey</creatorcontrib><creatorcontrib>Ueno, Takamasa</creatorcontrib><creatorcontrib>Pembe, Andrea</creatorcontrib><creatorcontrib>Nagu, Tumaini</creatorcontrib><creatorcontrib>Sunguya, Bruno</creatorcontrib><creatorcontrib>Aboud, Said</creatorcontrib><title>HIV virologic response, patterns of drug resistance mutations and correlates among adolescents and young adults: A cross-sectional study in Tanzania</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The emergence of HIV drug resistance mutations (DRMs) is of significant threat to achieving viral suppression (VS) in the quest to achieve global elimination targets. We hereby report virologic outcomes and patterns of acquired DRMs and its associated factors among adolescents and young adults (AYA) from a broader HIV drug resistance surveillance conducted in Tanzania.
Data of AYA was extracted from a cross-sectional study conducted in 36 selected facilities using a two-stage cluster sampling design. Dried blood spot (DBS) samples were collected and samples with a viral load (VL) ≥1000 copies/mL underwent genotyping for the HIV-1 pol gene. Stanford HIV database algorithm predicted acquired DRMs, Fisher's exact test and multivariable logistic regression assessed factors associated with DRMs and VS, respectively.
We analyzed data of 578 AYA on antiretroviral therapy (ART) for 9-15 and ≥ 36 months; among them, 91.5% and 88.2% had VS (VL<1000copies/mL) at early and late time points, respectively. Genotyping of 64 participants (11.2%) who had VL ≥1000 copies/ml detected 71.9% of any DRM. Clinically relevant DRMs were K103N, M184V, M41L, T215Y/F, L210W/L, K70R, D67N, L89V/T, G118R, E138K, T66A, T97A and unexpectedly absent K65R. Participants on a protease inhibitor (PI) based regimen were twice as likely to not achieve VS compared to those on integrase strand transfer inhibitors (INSTI). The initial VL done 6 months after ART initiation of ≥1000copies/mL was the primary factor associated with detecting DRMs (p = .019).
VS amongst AYA is lower than the third UNAIDs target. Additionally, a high prevalence of ADR and high levels of circulating clinically relevant DRMs may compromise the long-term VS in AYA. Furthermore, the first VL result of ≥1000copies/ml after ART initiation is a significant risk factor for developing DRMs. Thus, strict VL monitoring for early identification of treatment failure and genotypic testing during any ART switch is recommended to improve treatment outcomes for AYA.</description><subject>Adolescent</subject><subject>Adolescents</subject><subject>Adults</subject><subject>Algorithms</subject><subject>Anti-HIV Agents - pharmacology</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Antiviral agents</subject><subject>Biology and Life Sciences</subject><subject>Cross-Sectional Studies</subject><subject>Dosage and administration</subject><subject>Drug resistance</subject><subject>Drug Resistance, Viral - genetics</subject><subject>Drug 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virologic response, patterns of drug resistance mutations and correlates among adolescents and young adults: A cross-sectional study in Tanzania</title><author>Rugemalila, Joan ; Kamori, Doreen ; Kunambi, Peter ; Mizinduko, Mucho ; Sabasaba, Amon ; Masoud, Salim ; Msafiri, Frank ; Mugusi, Sabina ; Mutagonda, Rita ; Mlunde, Linda ; Amani, Davis ; Mboya, Erick ; Mahiti, Macdonald ; Ruhago, George ; Mushi, Jeremiah ; Sambu, Veryeh ; Mgomella, George ; Jullu, Boniface ; Maokola, Werner ; Njau, Prosper ; Mutayoba, Beatrice ; Barabona, Godfrey ; Ueno, Takamasa ; Pembe, Andrea ; Nagu, Tumaini ; Sunguya, Bruno ; Aboud, 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(Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rugemalila, Joan</au><au>Kamori, Doreen</au><au>Kunambi, Peter</au><au>Mizinduko, Mucho</au><au>Sabasaba, Amon</au><au>Masoud, Salim</au><au>Msafiri, Frank</au><au>Mugusi, Sabina</au><au>Mutagonda, Rita</au><au>Mlunde, Linda</au><au>Amani, Davis</au><au>Mboya, Erick</au><au>Mahiti, Macdonald</au><au>Ruhago, George</au><au>Mushi, Jeremiah</au><au>Sambu, Veryeh</au><au>Mgomella, George</au><au>Jullu, Boniface</au><au>Maokola, Werner</au><au>Njau, Prosper</au><au>Mutayoba, Beatrice</au><au>Barabona, Godfrey</au><au>Ueno, Takamasa</au><au>Pembe, Andrea</au><au>Nagu, Tumaini</au><au>Sunguya, Bruno</au><au>Aboud, Said</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>HIV virologic response, patterns of drug resistance mutations and correlates among adolescents and young adults: A cross-sectional study in Tanzania</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-02-23</date><risdate>2023</risdate><volume>18</volume><issue>2</issue><spage>e0281528</spage><epage>e0281528</epage><pages>e0281528-e0281528</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The emergence of HIV drug resistance mutations (DRMs) is of significant threat to achieving viral suppression (VS) in the quest to achieve global elimination targets. We hereby report virologic outcomes and patterns of acquired DRMs and its associated factors among adolescents and young adults (AYA) from a broader HIV drug resistance surveillance conducted in Tanzania.
Data of AYA was extracted from a cross-sectional study conducted in 36 selected facilities using a two-stage cluster sampling design. Dried blood spot (DBS) samples were collected and samples with a viral load (VL) ≥1000 copies/mL underwent genotyping for the HIV-1 pol gene. Stanford HIV database algorithm predicted acquired DRMs, Fisher's exact test and multivariable logistic regression assessed factors associated with DRMs and VS, respectively.
We analyzed data of 578 AYA on antiretroviral therapy (ART) for 9-15 and ≥ 36 months; among them, 91.5% and 88.2% had VS (VL<1000copies/mL) at early and late time points, respectively. Genotyping of 64 participants (11.2%) who had VL ≥1000 copies/ml detected 71.9% of any DRM. Clinically relevant DRMs were K103N, M184V, M41L, T215Y/F, L210W/L, K70R, D67N, L89V/T, G118R, E138K, T66A, T97A and unexpectedly absent K65R. Participants on a protease inhibitor (PI) based regimen were twice as likely to not achieve VS compared to those on integrase strand transfer inhibitors (INSTI). The initial VL done 6 months after ART initiation of ≥1000copies/mL was the primary factor associated with detecting DRMs (p = .019).
VS amongst AYA is lower than the third UNAIDs target. Additionally, a high prevalence of ADR and high levels of circulating clinically relevant DRMs may compromise the long-term VS in AYA. Furthermore, the first VL result of ≥1000copies/ml after ART initiation is a significant risk factor for developing DRMs. Thus, strict VL monitoring for early identification of treatment failure and genotypic testing during any ART switch is recommended to improve treatment outcomes for AYA.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36821538</pmid><doi>10.1371/journal.pone.0281528</doi><tpages>e0281528</tpages><orcidid>https://orcid.org/0000-0001-6939-5125</orcidid><orcidid>https://orcid.org/0000-0003-0563-8188</orcidid><orcidid>https://orcid.org/0000-0003-4852-4236</orcidid><orcidid>https://orcid.org/0000-0002-8090-3298</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2023-02, Vol.18 (2), p.e0281528-e0281528 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2779497681 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Adolescents Adults Algorithms Anti-HIV Agents - pharmacology Anti-HIV Agents - therapeutic use Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Antiviral agents Biology and Life Sciences Cross-Sectional Studies Dosage and administration Drug resistance Drug Resistance, Viral - genetics Drug therapy Evaluation Genotype Genotyping Health aspects HIV HIV infection HIV Infections - drug therapy HIV Infections - epidemiology Human immunodeficiency virus Humans Integrase Medicine and Health Sciences Mutation People and Places Pol gene Protease inhibitors Proteinase inhibitors Research and Analysis Methods Risk factors Sampling designs Tanzania - epidemiology Teenagers Viral Load Young Adult Young adults Youth |
| title | HIV virologic response, patterns of drug resistance mutations and correlates among adolescents and young adults: A cross-sectional study in Tanzania |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T02%3A31%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=HIV%20virologic%20response,%20patterns%20of%20drug%20resistance%20mutations%20and%20correlates%20among%20adolescents%20and%20young%20adults:%20A%20cross-sectional%20study%20in%20Tanzania&rft.jtitle=PloS%20one&rft.au=Rugemalila,%20Joan&rft.date=2023-02-23&rft.volume=18&rft.issue=2&rft.spage=e0281528&rft.epage=e0281528&rft.pages=e0281528-e0281528&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0281528&rft_dat=%3Cgale_plos_%3EA738317089%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2779497681&rft_id=info:pmid/36821538&rft_galeid=A738317089&rft_doaj_id=oai_doaj_org_article_0ff508ee46584e13ba22d47914c588f5&rfr_iscdi=true |