Prevalence of Transmitted Drug Resistance Mutations in HIV-1-Infected Drug-Naive Patients from Urban and Suburban Regions of Kenya

Onsongo, Simon; Abidi, Syed Hani; Khamadi, Samoel; Shah, Reena; Kageha, Sheila; Ojwang, P. J.; Ali, Syed; Okinda, Nancy

doi:10.1089/aid.2015.0026

Cited by 9 publications

(15 citation statements)

References 27 publications

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“…After a median duration of 6.5 years on ART, the rate of viral suppression among adolescents in this study was 80%, which was higher than the national prevalence of 63% reported in 2016. 6 This rate is comparable with studies in Eswatini and South Africa, at 84% and 85%, respectively. 19 , 24 However, this observed level of viral suppression falls short of the UNAIDS’ 90-90-90 target.…”

Section: Discussionsupporting

confidence: 83%

“…3 The improved viral suppression may be related to the launch of the “test and treat” guidelines in 2016 in Kenya, which placed emphasis on enhanced adherence counseling (EAC) and support for patients with high viral loads. 6 Patients with high viral loads receive three sessions of EAC after which a repeat viral load test was performed. Our findings suggest that the WHO target of 90% viral suppression is possible for adolescents in Kenya.…”

Section: Discussionmentioning

confidence: 99%

“…5 HIV drug resistance testing is not routinely done in Kenya, but previous studies show an increasing prevalence of transmitted antiretroviral drug resistance in ART-naïve patients. 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Viral Suppression Among Adolescents on Antiretroviral Therapy in Homa Bay County, Kenya: A Retrospective Cross-Sectional Study

Mwangi¹,

Wyk²

2021

HIV

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Background Despite the success in initiating adolescents living with HIV on antiretroviral therapy (ART), questions remain about factors affecting viral suppression. In Kenya, only 63% of adolescents (aged 10–19 years) on ART had achieved viral suppression in 2016. We investigated factors associated with viral suppression among adolescents initiated on ART before November 30, 2017 in Homa Bay County, Kenya. Methods A retrospective cross-sectional analysis of 908 adolescents registered on ART for at least 6 months and with at least one documented viral load in the last 12 months, in six health facilities in Homa Bay County was conducted. Data were extracted from the electronic medical records and exported into an excel spreadsheet. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with viral suppression and adjust for confounding, using Stata 12.0. Results Out of all participants, 80% (726) had achieved viral suppression (<1,000 copies of viral RNA/mL of blood at latest viral load count). After adjusting for other covariates, adolescents with good adherence to ART (AOR=2.3, 95% CI=1.38–3.84) and a most recent CD4 count of above 500 cells/mm 3 (AOR=1.87, 95% CI=1.13–3.08), were more likely to be virally suppressed. Adolescents on second line ART treatment (AOR=0.45, 95% CI=0.28–0.73) and having inadequate adherence to ART (AOR=0.26, 95% CI=0.11–63) were less likely to be virally suppressed. Conclusion Viral suppression for adolescents on ART in this study is significantly higher than the national prevalence in 2016 (80% vs 63%), but it is still below the WHO target of 90%. Enhanced adherence support for adolescents on ART should be implemented to improve long-term adherence. Specific interventions are needed to “rescue” adolescents on second-line ART regimens who may have a history of poor adherence.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Factors Associated with Viral Suppression Among Adolescents on Antiretroviral Therapy in Homa Bay County, Kenya: A Retrospective Cross-Sectional Study

Mwangi¹,

Wyk²

2021

HIV

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“…We found a similar PDR prevalence (9%-13%) across urban and rural sites, which was contrary to our expectation that PDR 1) 20 (0) 14 (118-24 39 7) 32 (7) 7 (025 -35 247 (30) 169 (24) 78 635-50 386 (27) 218 (18) 168 950+ 143 (13) 80 6 prevalence would be lower at the rural than the urban clinics. Whereas some previous studies have generally found lower PDR in rural settings [39][40][41][42][43][44][45][46][47][48][49], our more recent results may reflect improved access to ART in the rural regions. Our observed 12% PDR prevalence among 212 adult participants (11% among ARV-naive) at the rural Maseno clinic was slightly higher than the 9% TDR prevalence observed in another recently published study of 87 ARV-naive participants conducted in 2012, also based in Western Kenya [50], providing further evidence of PDR in this rural setting.…”

Section: Discussioncontrasting

confidence: 78%

Prevalence of Pre-antiretroviral-Treatment Drug Resistance by Gender, Age, and Other Factors in HIV-Infected Individuals Initiating Therapy in Kenya, 2013–2014

Silverman

Beck²,

Kiptinness

et al. 2017

The Journal of Infectious Diseases

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“…At least two of these studies [17,20] tested many subtype samples collected from around the world including Africa. These studies include the predominant HIV subtypes seen in Kenya such as subtype A, D, C, G and recombinants [21,22,36,37]. The good agreement seen between Aptima VL results and Abbott RT seen in this study also suggest that subtype quantification of Aptima is equivalent to that of Abbott RT for the HIV subtypes prevalent in Kenya.…”

Section: Plos Onesupporting

confidence: 70%

Prospective evaluation of accuracy of HIV viral load monitoring using the Aptima HIV Quant Dx assay with fingerstick and venous dried blood spots prepared under field conditions in Kenya

et al. 2021

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Quantification of HIV-1 RNA is essential for clinical management of HIV patients. The limited throughput and significant hands-on time required by most HIV Viral load (VL) tests makes it challenging for laboratories with high test volume, to turn around patient results quickly. The Hologic Aptima HIV-1 Quant Dx Assay (Aptima), has the potential to alleviate this burden as it is high throughput and fully automated. This assay is validated for both plasma and dried blood spots (DBS), which are commonly used in resource limited settings. The objective of this study was to compare the performance of Aptima to Abbott RealTime HIV-1 Assay (Abbott RT), which was used as reference. This was a cross-sectional prospective study where HIV VL in finger stick (FS) DBS, venous blood (VB) DBS and plasma, collected from 258 consenting adults visiting 5 medical facilities in Kenya, Africa were tested in Aptima. The results were compared to plasma VL in Abbott RT at the medical decision point (MDP) of 1000 copies/mL and across Aptima assay range. The total agreement at MDP between plasma HIV VL in Abbott RT and plasma, FS and VB DBS tested in Aptima were 97.7%, 92.2% and 95.3% respectively with kappa statistic of 0.95, 0.84 and 0.90. The positive and negative agreement for all 3 sample types were >92%. Regression analysis between VL in Abbott RT plasma and various sample types tested in Aptima had a Pearson’s correlation coefficient ≥0.91 with systematic bias of < 0.20 log copies/mL on Bland-Altman analysis. The high level of agreement in Aptima HIV VL results for all 3 sample types with Abbott RT plasma VL along with the high throughput, complete automation, and ease of use of the Panther platform makes Aptima a good option for HIV VL monitoring for busy laboratories with high volume of testing.

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Prevalence of Transmitted Drug Resistance Mutations in HIV-1-Infected Drug-Naive Patients from Urban and Suburban Regions of Kenya

Cited by 9 publications

References 27 publications

Factors Associated with Viral Suppression Among Adolescents on Antiretroviral Therapy in Homa Bay County, Kenya: A Retrospective Cross-Sectional Study

Factors Associated with Viral Suppression Among Adolescents on Antiretroviral Therapy in Homa Bay County, Kenya: A Retrospective Cross-Sectional Study

Prevalence of Pre-antiretroviral-Treatment Drug Resistance by Gender, Age, and Other Factors in HIV-Infected Individuals Initiating Therapy in Kenya, 2013–2014

Prospective evaluation of accuracy of HIV viral load monitoring using the Aptima HIV Quant Dx assay with fingerstick and venous dried blood spots prepared under field conditions in Kenya

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