BackgroundATCC HIV-1 drug resistance test kit was designed to detect HIV-1 drug resistance (HIVDR) mutations in the protease and reverse transcriptase genes for all HIV-1 group M subtypes and circulating recombinant forms. The test has been validated for both plasma and dried blood spot specimen types with viral load (VL) of ≥1000 copies/ml. We performed an in-country assessment on the kit to determine the genotyping sensitivity and its accuracy in detecting HIVDR mutations using plasma samples stored under suboptimal conditions.MethodsAmong 572 samples with VL ≥1000 copies/ml that had been genotyped by ViroSeq assay, 183 were randomly selected, including 85 successful genotyped and 98 unsuccessful genotyped samples. They were tested with ATCC kits following the manufacturer’s instructions. Sequence identity and HIVDR patterns were analysed with Stanford University HIV Drug Resistance HIVdb program.ResultsOf the 183 samples, 127 (69.4%) were successfully genotyped by either method. While ViroSeq system genotyped 85/183 (46.5%) with median VL of 32,971 (IQR: 11,150–96,506) copies/ml, ATCC genotyped 115/183 (62.8%) samples with median VL of 23,068 (IQR: 7,397–86,086) copies/ml. Of the 98 unsuccessful genotyped samples with ViroSeq assay, 42 (42.9%) samples with lower median VL of 13,906 (IQR: 6,122–72,329) copies/ml were successfully genotyped using ATCC. Sequence identity analysis revealed that the sequences generated by both methods were >98% identical and yielded similar HIVDR profiles at individual patient level.ConclusionThis study confirms that ATCC kit showed greater sensitivity in genotyping plasma samples stored in suboptimal conditions experiencing frequent and prolonged power outage. Thus, it is more sensitive particularly for subtypes A and A/G HIV-1 in resource-limited settings.

Background: Strict adherence requirement to antiretroviral drugs remains a key determinant of successful treatment outcome. Drug regimen complexity has been identified as a factor that discourages adherence to antiretroviral therapy. Several measures are available to assess drug adherence each with its strengths and weaknesses. Only few of these measures are cost effective and can be used in resource limited settings. Objective: To determine the effect of number of pills, dosing frequency, and concomitant drugs on adherence to antiretroviral drug therapy. Method: This is a cross-sectional study utilizing a semi-structured questionnaire. Adherence to antiretroviral therapy was measured using self-report and prescription refill. The total number of pills and the dosing frequency were calculated and its association with poor adherence tested via a logistics regression model. Results: Majority of the respondents were females (69.5%), aged 31-40 years (42.2%), married (68.5%), had greater than one pill in their drug regimen (84%), were on twice daily regimen (56.4%) and on other non-ARV drugs (59.9%). An assessment of the adherence levels showed that 140(37.4%) and 161(43%) of the interviewed patients had poor adherence level of ≤ 95% as measured via self-report and pharmacy pick up respectively. At multivariate analysis taking other non-ARV drugs and taking 2 or more ARV pills were predictors of poor adherence to antiretroviral drugs (OR=9, 4.8-16.69) and (OR=0.19, 0.08-0.5) respectively. Conclusion: The number of times drugs are taken in a day did not affect adherence in this study however, increased number of pills and addition of other concomitant medications to an antiretroviral regimen discouraged adherence.