High Level of Pre-Treatment HIV-1 Drug Resistance and Its Association with HLA Class I-Mediated Restriction in the Pumwani Sex Worker Cohort

Willim, Rachel; Shadabi, Elnaz; Raghavan, Subharekha; Li, Lin; Balshaw, Robert; Kimani, Joshua; Plummer, Francis A.; Luo, Ma; Liang, Binhua

doi:10.3390/v14020273

Cited by 4 publications

(2 citation statements)

References 35 publications

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“…A recent study on the oldest FSW cohort, Pumwani, found a high level of PDR (38%) across all ART classes. [ 9 ] A systematic review of 332 datasets with 63,111 subjects focusing on key populations found that the pooled prevalence estimate of any PDR was high among men who have sex with men at 13.0% (95% CI: 11.0–14.0), and sex workers at 17.0% (95% CI: 6.0–32.0), but lower among injecting drug users at 7.0% (95% CI: 5.0–10.0). [ 10 ] Of concern is the rise in PDR in the general population to non-nucleoside reverse transcriptase inhibitors (NNRTIs) after the ART scale-up, with substantial increases in resistance to NNRTI in East Africa (36%, 95% CI: 21–52) and southern Africa (23% 95% CI: 7–42).…”

Section: Introductionmentioning

confidence: 99%

Age and CD4+ T cell counts are inversely associated with HIV drug resistance mutations in treatment naive female sex workers

Mulinge,

Oluoch,

Abisi

et al. 2023

Medicine

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The increasing prevalence of human immunodeficiency virus (HIV) drug resistance mutations (HIVDRM) in untreated seropositive persons has consequences for future treatment options. This is extremely important in key populations such as female sex workers (FSWs), where the prevalence of pretreatment drug resistance (PDR) and associated risk factors are unknown. In this study, we analyzed PDR and associated risk factors in recently diagnosed and treatment-naive FSWs in Nairobi, Kenya. In this cross-sectional study, we used 64 HIV-seropositive plasma samples collected from FSWs between November 2020 and April 2021. To identify HIVDRM, the pol gene was amplified and genotyped using sanger sequencing. The effects of age, tropism, CD4+ T cell count, subtype, and location on HIVDRM counts were examined using Poisson regression. Overall, the prevalence of PDR was 35.9% (95% CI: 24.3–48.9), which was strongly influenced by K103N and M184V mutations, which confer resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) and nucleoside reverse transcriptase inhibitors (NRTI), respectively. Subtype A1 was predominant followed by subtype D with a notable increase in inter-subtype recombinants. We found statistically significant evidence that age was inversely related to HIVDRM. A FSW who is 1 year older had 12% less HIVDRM (incidence rate ratios [IRR]: 0.88; 95% CI: 0.82–0.95; P < .001), after adjusting for CD4+ T cell count, subtype, location, and tropism. Similarly, an increase in CD4+ T cell count by 1 unit, was associated with 0.4% fewer HIVDRM (IRR: 0.996; 95% CI: 0.994–0.998; P = .001), while controlling for the other variables. HIV-1 tropism was not associated with HIVDRM counts. In conclusion, our findings show a high prevalence of NNRTIs. Lower CD4+ T cell counts and younger age were significant risk factors that influenced HIVDRM loads. This finding underscores the relevance of targeted interventions and the importance of continuing to focus on FSWs as a way of addressing the HIV epidemic.

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Section: Introductionmentioning

confidence: 99%

Age and CD4+ T cell counts are inversely associated with HIV drug resistance mutations in treatment naive female sex workers

Mulinge,

Oluoch,

Abisi

et al. 2023

Medicine

Self Cite

View full text Add to dashboard Cite

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“…Willim et al [23] analyzed the prevalence of pre-antiretroviral therapy (ART) drug resistance mutations (DRMs) in a Kenyan population and observed high levels of HIV drug resistance against all classes of antiretroviral drugs, including the current first-line ART regimens in Africa. The authors also detected some correlation between DRMs and host HLA class I genes and suggested that the development of DRMs may be influenced by HLA class I-restricted immunity.…”

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confidence: 99%

Special Issue “Viral Infections in Developing Countries”

Campos

Arruda

Fonseca

2022

Viruses

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HIV viral suppression in the era of dolutegravir use: Findings from a national survey in Tanzania

Kamori,

Barabona,

Maokola

et al. 2024

PLoS ONE

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Background Tanzania has made significant progress in improving access to HIV care and treatment. However, virologic suppression among people living with HIV (PLHIV) has not been fully realized. In March 2019, Tanzania introduced a World Health Organization (WHO)—recommended dolutegravir-based regimen as the default first-line regimen. Eighteen months later we investigated the HIV viral suppression rates and the factors associated with lack of viral suppression among PLHIV (children and adults) in Tanzania. Methodology A cross-sectional survey was conducted from September to December 2020 among PLHIV on antiretroviral therapy (ART) in Tanzania. Whole blood samples, demographic data and clinical information were obtained from eligible adults (≥15 years) and children (< 15 years) attending thirty-six HIV care and treatment centres located in 22 regions of Tanzania mainland. A whole blood sample from each participant was processed into plasma and HIV viral load was estimated using real-time PCR. HIV viral suppression was defined at a cut-off of < 50 copies/mL as recommended by WHO. Analyses were conducted using descriptive statistics to establish the national representative prevalence of viral suppression, and logistic regression analyses to determine independent factors associated with non-suppression. Results A total of 2,039 PLHIV on ART were recruited; of these, adults and children were 57.5% (n = 1173) and 42.5% (n = 866), respectively. Among the adult population, the mean age and standard deviation (SD) was 42.1 ± 12.4 years, with 64.7% being female. Among children, the mean age and SD were 9.6 ± 3 years, and 53.2% were female. Overall viral suppression at < 50 copies/mL (undetectable) was achieved in 87.8% of adults and 74.4% of children. Adults and children on dolutegravir-based regimen recorded viral suppression rates of 89.7% and 85.1% respectively. Factors independently associated with lack of viral suppression status in the adult population were age and ART adherence while in the children population, the factors were sex, ART adherence, and current ART regimen (p<0.05). Conclusion Dolutegravir-based regimens are promising to help attain epidemic control in Tanzania. More efforts especially on ART adherence are needed to attain optimal treatment outcomes for children and adults PLHIV in Tanzania.

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High Level of Pre-Treatment HIV-1 Drug Resistance and Its Association with HLA Class I-Mediated Restriction in the Pumwani Sex Worker Cohort

Cited by 4 publications

References 35 publications

Age and CD4+ T cell counts are inversely associated with HIV drug resistance mutations in treatment naive female sex workers

Age and CD4+ T cell counts are inversely associated with HIV drug resistance mutations in treatment naive female sex workers

Special Issue “Viral Infections in Developing Countries”

HIV viral suppression in the era of dolutegravir use: Findings from a national survey in Tanzania

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