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Low prevalence of archived integrase strand transfer inhibitors resistance associated mutations in Botswana before the roll out of dolutegravir based first line antiretroviral therapy.
Front Microbiol
October 2024
Botswana Harvard Health Partnership, Gaborone, Botswana.
Article Synopsis
- - The study assessed the prevalence of drug resistance mutations (DRMs) to integrase strand transfer inhibitors (INSTIs) just before Botswana switched to dolutegravir (DTG) for first-line HIV treatment in 2016, analyzing over 5,000 HIV-1 sequences from various individuals.
- - Results indicated that the overall prevalence of significant INSTI DRMs was 1.11%, with higher rates found in those who had not received antiretroviral treatment (ART-naïve individuals) compared to those who had (ART-experienced individuals).
- - Notable mutations associated with INSTI resistance included E138K and G140R, but high-level resistance to newer drugs like dolutegravir
Trends and Patterns of HIV Transmitted Drug Resistance in China From 2018 to 2023.
J Infect Dis
December 2024
Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), Beijing Academy of Preventive Medicine, Beijing.
Article Synopsis
- The study examined drug resistance in HIV among newly diagnosed individuals in China from 2018 to 2023 to adapt treatment guidelines.
- Out of over 22,000 individuals, 4.36% had at least one transmitted drug resistance (TDR) mutation, with the most common being linked to nonnucleoside reverse transcriptase inhibitors.
- The prevalence of TDR mutations notably increased from 4.05% to 5.39% over the study years, supporting the ongoing use of NNRTI-based treatment regimens for HIV.
HIV Drug Resistance in Newly Diagnosed Young Children in the Western Cape, South Africa.
Pediatr Infect Dis J
October 2024
From the Centre for Infectious Disease Epidemiology and Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Background: Pretreatment of HIV drug resistance among children living with HIV (CLHIV) can compromise antiretroviral therapy (ART) effectiveness. Resistance may be transmitted directly from mothers or acquired following exposure to antiretrovirals consumed through breastfeeding or administered as prophylaxis.
Methods: We performed resistance testing in children aged <3 years, newly diagnosed with HIV in Western Cape, South Africa (2021-2022), who either (1) acquired HIV via possible breastfeeding transmission from mothers who received ART (any regimen) during pregnancy/postpartum and/or (2) were exposed to protease inhibitors or integrase strand transfer inhibitors (INSTIs) in utero.
Virologic Failure and Drug Resistance After Programmatic Switching to Dolutegravir-based First-line Antiretroviral Therapy in Malawi and Zambia.
Clin Infect Dis
June 2024
KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), School of Laboratory Medicine & Medical Sciences, University of KwaZulu-Natal, Durban, South Africa.
Background: People with human immunodeficiency virus (PWH) on first-line, nonnucleoside reverse-transcriptase inhibitor-based antiretroviral therapy (ART) were routinely switched to tenofovir-lamivudine-dolutegravir. We examined virologic outcomes and drug resistance in ART programs in Malawi, where switching was irrespective of viral load, and Zambia, where switching depended on a viral load <1000 copies/mL in the past year.
Methods: We compared the risk of viremia (≥400 copies/mL) at 1 and 2 years by viral load at switch and between countries using exact methods and logistic regression adjusted for age and sex.
Virologic outcomes with tenofovir-lamivudine-dolutegravir in adults failing PI-based second-line ART.
South Afr J HIV Med
April 2024
Department of Medicine, Faculty of Health Science, University of Cape Town, Cape Town, South Africa.
Background: In South African antiretroviral guidelines, selected patients failing second-line protease inhibitor (PI)-based therapy qualify for genotypic resistance testing - those with PI resistance receive darunavir-based third-line regimens; those without PI resistance continue current regimen with adherence support. The Western Cape province, from September 2020, implemented a strategy of tenofovir-lamivudine-dolutegravir (TLD) for patients, provided there was no tenofovir resistance, irrespective of PI resistance.
Objectives: To evaluate virologic outcomes with TLD among adults failing second-line PI regimens with no tenofovir resistance.
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