Resistance to protease inhibitors among persons living with HIV in Ghana: a case for viral load and drug resistance monitoring.
HIV care continuum
HIV-1 drug resistance test
HIV-1 viral load
Protease inhibitors
Second-line ART
Treatment failure
Journal
Virology journal
ISSN: 1743-422X
Titre abrégé: Virol J
Pays: England
ID NLM: 101231645
Informations de publication
Date de publication:
20 Jul 2024
20 Jul 2024
Historique:
received:
03
12
2023
accepted:
30
03
2024
medline:
21
7
2024
pubmed:
21
7
2024
entrez:
20
7
2024
Statut:
epublish
Résumé
Routine viral load and drug resistance testing are well supported in most resource-rich settings and provide valuable benefits in the clinical care of PLWH in these communities. Undoubtedly, there exist financial and political constraints for the scale-up of viral load and drug resistance testing in Sub-Saharan Africa. To achieve the global UNAIDS 95/95/95 targets, there is the need to bridge this inequity in patient care and allow for a universal approach that leaves no community behind. Venous blood from 96 PLWH on second-line ART from Korle-Bu Teaching Hospital were collected and processed into plasma for CD4 Out of the 96 PLWH, 37 experienced virological failure with 8 patients' samples successfully sequenced. The predominant HIV-1 subtype identified was CRF02_AG (6/8, 75.0%) with 12.5% (1/8) each of CFR06_cpx infection and one case unable to subtype. The major PI resistance mutations identified were; M46I, I54V, V82A, I47V, I84V and L90M. Persons living with HIV who had experienced virologic failure in this study harboured drug resistance mutations to PI, thus compromise the effectiveness of the drugs in the second line. Resistance testing is strongly recommended prior to switching to a new regimen. This will help to inform the choice of drug and to achieve optimum therapeutic outcome among PLWH in Ghana.
Identifiants
pubmed: 39033275
doi: 10.1186/s12985-024-02354-6
pii: 10.1186/s12985-024-02354-6
doi:
Substances chimiques
HIV Protease Inhibitors
0
HIV Protease
EC 3.4.23.-
RNA, Viral
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
159Informations de copyright
© 2024. The Author(s).
Références
WHO. World Health Organization. HIV and AIDS- Key facts. 2023.
GAC, Ghana AIDS. Commission: People Living with HIV in Ghana. 2023.
WB. The World Bank. Prevalence of HIV, total (% of population ages 15–49.)– Ghana 2021.
Hammer SM, Saag MS, Schechter M, Montaner JS, Schooley RT, Jacobsen DM, et al. Treatment for adult HIV infection: 2006 recommendations of the International AIDS Society–USA panel. JAMA. 2006;296(7):827–43.
doi: 10.1001/jama.296.7.827
pubmed: 16905788
Gandhi RT, Bedimo R, Hoy JF, Landovitz RJ, Smith DM, Eaton EF, et al. Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2022 recommendations of the International Antiviral Society–USA panel. JAMA. 2023;329(1):63–84.
doi: 10.1001/jama.2022.22246
pubmed: 36454551
Garone D, Conradie K, Patten G, Cornell M, Goemaere E, Kunene J, et al. High rate of virological re-suppression among patients failing second-line antiretroviral therapy following enhanced adherence support: a model of care in Khayelitsha, South Africa. South Afr J HIV Med. 2013;14(4):170–5.
doi: 10.4102/sajhivmed.v14i4.52
Nichols BE, Sigaloff KC, Kityo C, Hamers RL, Baltussen R, Bertagnolio S, et al. Increasing the use of second-line therapy is a cost‐effective approach to prevent the spread of drug‐resistant HIV: a mathematical modelling study. J Int AIDS Soc. 2014;17(1):19164.
doi: 10.7448/IAS.17.1.19164
pubmed: 25491351
pmcid: 4260459
Hosseinipour MC, Gupta RK, Van Zyl G, Eron JJ, Nachega JB. Emergence of HIV drug resistance during first-and second-line antiretroviral therapy in resource-limited settings. J Infect Dis. 2013;207(suppl2):S49–56.
doi: 10.1093/infdis/jit107
pubmed: 23687289
pmcid: 3708738
Swenson LC, Min JE, Woods CK, Cai E, Li JZ, Montaner JS, et al. HIV drug resistance detected during low-level viremia is associated with subsequent virologic failure. AIDS. 2014;28(8):1125.
doi: 10.1097/QAD.0000000000000203
pubmed: 24451160
NACP-Ghana. National AIDS Control Programme: 2019 Annual Report-June 2020. 2019:38.
NACP-Tanzania. National AIDS Control Program United Republic of Tanzania: National Guidelines for the Management of HIV and AIDS. 2019.
Jenkins SY, Resar D, Panos Z, Staple A, Watkins M, Ripin D, et al. Securing accelerated access to long-acting injectable cabotegravir for HIV prevention in low‐and middle‐income countries. J Int AIDS Soc. 2023;26:e26101.
doi: 10.1002/jia2.26101
pubmed: 37439082
pmcid: 10338995
Meyer-Rath G, Jamieson L, Pillay Y. What will it take for an injectable ARV to change the face of the HIV epidemic in high‐prevalence countries? Considerations regarding drug costs and operations. J Int AIDS Soc. 2023;26:e26106.
doi: 10.1002/jia2.26106
pubmed: 37439062
pmcid: 10338998
Fujisaki S, Fujisaki S, Ibe S, Asagi T, Itoh T, Yoshida S, et al. Performance and quality assurance of genotypic drug-resistance testing for human immunodeficiency virus type 1 in Japan. Jpn J Infect Dis. 2007;60(2/3):113.
doi: 10.7883/yoken.JJID.2007.113
pubmed: 17515643
Sia D, Onadja Y, Hajizadeh M, Heymann SJ, Brewer TF, Nandi A. What explains gender inequalities in HIV/AIDS prevalence in sub-saharan Africa? Evidence from the demographic and health surveys. BMC Public Health. 2016;16(1):1–18.
doi: 10.1186/s12889-016-3783-5
Badri M, Lawn SD, Wood R. Utility of CD4 cell counts for early prediction of virological failure during antiretroviral therapy in a resource-limited setting. BMC Infect Dis. 2008;8(1):1–8.
doi: 10.1186/1471-2334-8-89
Bennett DE. The requirement for surveillance of HIV drug resistance within antiretroviral rollout in the developing world. Curr Opin Infect Dis. 2006;19(6):607–14.
doi: 10.1097/QCO.0b013e3280109ff1
pubmed: 17075338
Organization WH. Guidelines: updated recommendations on HIV prevention, infant diagnosis, antiretroviral initiation and monitoring. 2021. https://iris.who.int/bitstream/handle/10665/340190/9789240022232-eng.pdf ; [Accessed March 14, 2024].
Broyles LN, Luo R, Boeras D, Vojnov L. The risk of sexual transmission of HIV in individuals with low-level HIV viraemia: a systematic review. Lancet. 2023.
Montarroyos UR, Miranda-Filho DB, César CC, Souza WV, Lacerda HR, Militão Albuquerque MFP, et al. Factors related to changes in CD4 + T-cell counts over time in patients living with HIV/AIDS: a multilevel analysis. PLoS ONE. 2014;9(2):e84276.
doi: 10.1371/journal.pone.0084276
pubmed: 24505247
pmcid: 3914785
Gathe JC Jr, Ive P, Wood R, Schürmann D, Bellos NC, DeJesus E, et al. SOLO: 48-week efficacy and safety comparison of once-daily fosamprenavir/ritonavir versus twice-daily nelfinavir in naive HIV-1-infected patients. AIDS. 2004;18(11):1529–37.
doi: 10.1097/01.aids.0000131332.30548.92
pubmed: 15238771
Aggleton P, Yankah E, Crewe M. Education and HIV/AIDS—30 years on. AIDS Educ Prev. 2011;23(6):495–507.
doi: 10.1521/aeap.2011.23.6.495
pubmed: 22201234
Govathson C, Ndlovu N, Rambally-Greener L, Schmucker L, Chetty-Makkan CM, Miot J et al. Increasing HIV treatment literacy among people living with HIV using a novel health communication aid: evidence from KwaZulu Natal province, South Africa. medRxiv. 2023:2023.06. 15.23291430.
Mo H, King MS, King K, Molla A, Brun S, Kempf DJ. Selection of resistance in protease inhibitor-experienced, human immunodeficiency virus type 1-infected subjects failing lopinavir-and ritonavir-based therapy: mutation patterns and baseline correlates. J Virol. 2005;79(6):3329–38.
doi: 10.1128/JVI.79.6.3329-3338.2005
pubmed: 15731227
pmcid: 1075714
Colonno R, Rose R, McLaren C, Thiry A, Parkin N, Friborg J. Identification of I50L as the signature atazanavir (ATV)-resistance mutation in treatment-naive HIV-1-infected patients receiving ATV-containing regimens. J Infect Dis. 2004;189(10):1802–10.
doi: 10.1086/386291
pubmed: 15122516
Chimukangara B, Lessells RJ, Sartorius B, Gounder L, Manyana S, Pillay M, et al. HIV-1 drug resistance in adults and adolescents on protease inhibitor-based antiretroviral therapy in KwaZulu-Natal Province, South Africa. J Global Antimicrob Resist. 2022;29:468–75.
doi: 10.1016/j.jgar.2021.10.023
Bircher RE, Ntamatungiro AJ, Glass TR, Mnzava D, Nyuri A, Mapesi H, et al. High failure rates of protease inhibitor-based antiretroviral treatment in rural Tanzania–A prospective cohort study. PLoS ONE. 2020;15(1):e0227600.
doi: 10.1371/journal.pone.0227600
pubmed: 31929566
pmcid: 6957142