HIV drug resistance profile in South Africa: Findings and implications from the 2017 national HIV household survey.
Adolescent
Adult
Age Factors
Anti-HIV Agents
/ pharmacology
Child
Child, Preschool
Cross-Sectional Studies
Dried Blood Spot Testing
/ statistics & numerical data
Drug Resistance, Viral
Female
HIV Infections
/ blood
HIV-1
/ drug effects
Health Surveys
/ statistics & numerical data
Humans
Infant
Infant, Newborn
Male
Medication Adherence
/ statistics & numerical data
Sex Factors
South Africa
Young Adult
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
26
05
2020
accepted:
08
10
2020
entrez:
4
11
2020
pubmed:
5
11
2020
medline:
29
12
2020
Statut:
epublish
Résumé
HIV drug resistance (HIVDR) testing was included in the 2017 South African national HIV household survey. We describe the prevalence of HIVDR by drug class, age, sex and antiretroviral drugs (ARV) status. Dried blood were spots tested for HIV, with Viral load (VL), exposure to ARVs and HIVDR testing among those HIV positive. HIVDR testing was conducted on samples with VL ≥1000 copies/ml using Next Generation Sequencing. Weighted percentages of HIVDR are reported. 697/1,105 (63%) of HIV positive samples were sequenced. HIVDR was detected in samples from 200 respondents (27.4% (95% confidence interval (CI) 22.8-32.6)). Among these 130 (18.9% (95% CI 14.8-23.8)), had resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) only, 63 (7.8% (95% CI 5.6-10.9)) resistance to NNRTIs and nucleoside reverse transcriptase inhibitors, and 3 (0.5% (95% CI 0.1-2.1)) resistance to protease inhibitors. Sixty-five (55.7% (95% CI 42.6-67.9) of ARV-positive samples had HIVDR compared to 112 (22.8% (95% CI 17.7-28.7)), in ARV-negative samples. HIVDR was found in 75.6% (95% CI 59.2-87.3), n = 27, samples from respondents who reported ARV use but tested ARV-negative, and in 15.3% (95% CI 6.3-32.8), n = 7, respondents who reported no ARV use and tested ARV-negative. There were no significant age and sex differences in HIVDR. 27% of virally unsuppressed respondents had HIVDR, increasing to 75% among those who had discontinued ARV. Our findings support strengthening first-line ARV regimens by including drugs with a higher resistance barrier and treatment adherence strategies, and close monitoring of HIVDR.
Sections du résumé
BACKGROUND
HIV drug resistance (HIVDR) testing was included in the 2017 South African national HIV household survey. We describe the prevalence of HIVDR by drug class, age, sex and antiretroviral drugs (ARV) status.
METHODS
Dried blood were spots tested for HIV, with Viral load (VL), exposure to ARVs and HIVDR testing among those HIV positive. HIVDR testing was conducted on samples with VL ≥1000 copies/ml using Next Generation Sequencing. Weighted percentages of HIVDR are reported.
RESULTS
697/1,105 (63%) of HIV positive samples were sequenced. HIVDR was detected in samples from 200 respondents (27.4% (95% confidence interval (CI) 22.8-32.6)). Among these 130 (18.9% (95% CI 14.8-23.8)), had resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) only, 63 (7.8% (95% CI 5.6-10.9)) resistance to NNRTIs and nucleoside reverse transcriptase inhibitors, and 3 (0.5% (95% CI 0.1-2.1)) resistance to protease inhibitors. Sixty-five (55.7% (95% CI 42.6-67.9) of ARV-positive samples had HIVDR compared to 112 (22.8% (95% CI 17.7-28.7)), in ARV-negative samples. HIVDR was found in 75.6% (95% CI 59.2-87.3), n = 27, samples from respondents who reported ARV use but tested ARV-negative, and in 15.3% (95% CI 6.3-32.8), n = 7, respondents who reported no ARV use and tested ARV-negative. There were no significant age and sex differences in HIVDR.
CONCLUSION
27% of virally unsuppressed respondents had HIVDR, increasing to 75% among those who had discontinued ARV. Our findings support strengthening first-line ARV regimens by including drugs with a higher resistance barrier and treatment adherence strategies, and close monitoring of HIVDR.
Identifiants
pubmed: 33147285
doi: 10.1371/journal.pone.0241071
pii: PONE-D-20-15855
pmc: PMC7641411
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0241071Subventions
Organisme : PEPFAR
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist
Références
Clin Infect Dis. 2012 May;54 Suppl 4:S334-8
pubmed: 22544199
AIDS Res Hum Retroviruses. 2019 Feb;35(2):129-138
pubmed: 30430843
Afr J AIDS Res. 2016;15(1):67-75
pubmed: 27002359
AIDS Res Hum Retroviruses. 2012 Jun;28(6):558-65
pubmed: 22251009
Lancet Infect Dis. 2018 Mar;18(3):346-355
pubmed: 29198909
J Antimicrob Chemother. 2017 Nov 01;72(11):3141-3148
pubmed: 28981637
J Clin Microbiol. 2014 Aug;52(8):2868-75
pubmed: 24871219
South Afr J HIV Med. 2017 Jul 15;18(1):776
pubmed: 29568644
J Acquir Immune Defic Syndr. 2011 Nov 1;58(3):233-40
pubmed: 21709569
Clin Infect Dis. 2012 May;54 Suppl 4:S273-9
pubmed: 22544187
Lancet Infect Dis. 2011 Oct;11(10):750-9
pubmed: 21802367
Nat Med. 2012 Sep;18(9):1378-85
pubmed: 22941277
J Acquir Immune Defic Syndr. 2015 Dec 15;70(5):515-9
pubmed: 26262777
Lancet. 2012 Oct 6;380(9849):1250-8
pubmed: 22828485
J Med Virol. 2011 Sep;83(9):1508-13
pubmed: 21739439
PLoS One. 2016 Dec 1;11(12):e0166305
pubmed: 27907009
Antivir Ther. 2019;24(3):203-210
pubmed: 30741163
Top Antivir Med. 2017 Dec/Jan;24(4):132-133
pubmed: 28208121
Clin Infect Dis. 2008 May 15;46(10):1589-97
pubmed: 18419495
PLoS One. 2011;6(11):e28184
pubmed: 22132237
J Antimicrob Chemother. 2016 May;71(5):1361-6
pubmed: 26929269
AIDS. 2010 Apr 24;24(7):1007-12
pubmed: 20397305
PLoS One. 2012;7(8):e42996
pubmed: 22952625
J Acquir Immune Defic Syndr. 2015 Apr 15;68(5):527-35
pubmed: 25585301
Clin Infect Dis. 2006 Jun 1;42(11):1608-18
pubmed: 16652319
J Infect Dis. 2013 Jun 15;207 Suppl 2:S57-62
pubmed: 23687290