Publications by authors named "K Steegen"
Article Synopsis
- Doravirine (DOR) is a new HIV treatment that works against some drug-resistant strains, but its effectiveness against non-B subtypes like HIV-1 subtype C is not fully understood.
- The study used South African data to examine how certain known mutations associated with resistance affect DOR susceptibility, finding that mutations such as V106M and Y188L significantly reduce DOR effectiveness.
- The research emphasizes the importance of genotypic drug resistance testing before starting DOR-based therapy, especially in patients with a history of efavirenz or nevirapine treatment failures.*
Article Synopsis
- Millions of Africans on dolutegravir-based ART are facing challenges with dolutegravir resistance, as detailed clinical management is lacking.
- A review of HIV drug resistance data shows that out of 89 cases, 24 exhibited dolutegravir resistance mutations, with older age and high NRTI resistance linked to this resistance.
- Despite a high mortality rate post-treatment modification, most individuals who remained in the program achieved good viral load outcomes; further research on managing dolutegravir resistance in treatment-experienced patients is necessary.
• Human immunodeficiency virus (HIV) drug resistance has implications for antiretroviral treatment strategies and for containing the HIV pandemic because the development of HIV drug resistance leads to the requirement for antiretroviral drugs that may be less effective, less well-tolerated, and more expensive than those used in first-line regimens. • HIV drug resistance studies are designed to determine which HIV mutations are selected by antiretroviral drugs and, in turn, how these mutations affect antiretroviral drug susceptibility and response to future antiretroviral treatment regimens. • Such studies collectively form a vital knowledge base essential for monitoring global HIV drug resistance trends, interpreting HIV genotypic tests, and updating HIV treatment guidelines.
View Article and Find Full Text PDFMonitoring of HIV drug resistance (HIVDR) remains critical for ensuring countries attain and sustain the global goals for ending HIV as a public health threat by 2030. On an individual patient level, drug resistance results assist in ensuring unnecessary treatment switches are avoided and subsequent regimens are tailored on a case-by-case basis, should resistance be detected. Although there is a disparity in access to HIVDR testing in high-income countries compared to low- and middle-income countries (LMICS), more LMICs have now included HIVDR testing for individual patient management in some groups of patients.
View Article and Find Full Text PDFResistance is common in paediatric patients failing ART in South Africa.
J Antimicrob Chemother
May 2023
Background: Minimal data exist on HIV drug resistance patterns and prevalence among paediatric patients failing ART in resource-limited settings. We assessed levels of HIV drug resistance in children with virological failure.
Methods: This cross-sectional study, performed from March 2017 to March 2019 in South Africa, enrolled HIV-positive children aged ≤19 years, receiving ART through public health facilities with recent evidence suggestive of virological failure (at least one viral load ≥1000 copies/mL), across 45 randomly selected high-volume clinics from all nine provinces.