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HIV drug resistance among adults initiating antiretroviral therapy in Uganda
BACKGROUND: WHO revised their HIV drug resistance (HIVDR) monitoring strategy in 2014, enabling countries to generate nationally representative HIVDR prevalence estimates from surveys conducted using this methodology. In 2016, we adopted this strategy in Uganda and conducted an HIVDR survey among ad...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361362/ https://www.ncbi.nlm.nih.gov/pubmed/33993252 http://dx.doi.org/10.1093/jac/dkab159 |
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author | Watera, Christine Ssemwanga, Deogratius Namayanja, Grace Asio, Juliet Lutalo, Tom Namale, Alice Sanyu, Grace Ssewanyana, Isaac Gonzalez-Salazar, Jesus Fidel Nazziwa, Jamirah Nanyonjo, Maria Raizes, Elliot Kabuga, Usher Mwangi, Christina Kirungi, Wilford Musinguzi, Joshua Mugagga, Kaggwa Mbidde, Edward Katongole Kaleebu, Pontiano |
author_facet | Watera, Christine Ssemwanga, Deogratius Namayanja, Grace Asio, Juliet Lutalo, Tom Namale, Alice Sanyu, Grace Ssewanyana, Isaac Gonzalez-Salazar, Jesus Fidel Nazziwa, Jamirah Nanyonjo, Maria Raizes, Elliot Kabuga, Usher Mwangi, Christina Kirungi, Wilford Musinguzi, Joshua Mugagga, Kaggwa Mbidde, Edward Katongole Kaleebu, Pontiano |
author_sort | Watera, Christine |
collection | PubMed |
description | BACKGROUND: WHO revised their HIV drug resistance (HIVDR) monitoring strategy in 2014, enabling countries to generate nationally representative HIVDR prevalence estimates from surveys conducted using this methodology. In 2016, we adopted this strategy in Uganda and conducted an HIVDR survey among adults initiating or reinitiating ART. METHODS: A cross-sectional survey of adults aged ≥18 years initiating or reinitiating ART was conducted at 23 sites using a two-stage cluster design sampling method. Participants provided written informed consent prior to enrolment. Whole blood collected in EDTA vacutainer tubes was used for preparation of dried blood spot (DBS) specimens or plasma. Samples were shipped from the sites to the Central Public Health Laboratory (CPHL) for temporary storage before transfer to the Uganda Virus Research Institute (UVRI) for genotyping. Prevalence of HIVDR among adults initiating or reinitiating ART was determined. RESULTS: Specimens from 491 participants (median age 32 years and 61.5% female) were collected between August and December 2016. Specimens from 351 participants were successfully genotyped. Forty-nine had drug resistance mutations, yielding an overall weighted HIVDR prevalence of 18.2% with the highest noted for NNRTIs at 14.1%. CONCLUSIONS: We observed a high HIVDR prevalence for NNRTIs among adults prior to initiating or reinitiating ART in Uganda. This is above WHO’s recommended threshold of 10% when countries should consider changing from NNRTI- to dolutegravir-based first-line regimens. This recommendation was adopted in the revised Ugandan ART guidelines. Dolutegravir-containing ART regimens are preferred for first- and second-line ART regimens. |
format | Online Article Text |
id | pubmed-8361362 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-83613622021-08-13 HIV drug resistance among adults initiating antiretroviral therapy in Uganda Watera, Christine Ssemwanga, Deogratius Namayanja, Grace Asio, Juliet Lutalo, Tom Namale, Alice Sanyu, Grace Ssewanyana, Isaac Gonzalez-Salazar, Jesus Fidel Nazziwa, Jamirah Nanyonjo, Maria Raizes, Elliot Kabuga, Usher Mwangi, Christina Kirungi, Wilford Musinguzi, Joshua Mugagga, Kaggwa Mbidde, Edward Katongole Kaleebu, Pontiano J Antimicrob Chemother Original Research BACKGROUND: WHO revised their HIV drug resistance (HIVDR) monitoring strategy in 2014, enabling countries to generate nationally representative HIVDR prevalence estimates from surveys conducted using this methodology. In 2016, we adopted this strategy in Uganda and conducted an HIVDR survey among adults initiating or reinitiating ART. METHODS: A cross-sectional survey of adults aged ≥18 years initiating or reinitiating ART was conducted at 23 sites using a two-stage cluster design sampling method. Participants provided written informed consent prior to enrolment. Whole blood collected in EDTA vacutainer tubes was used for preparation of dried blood spot (DBS) specimens or plasma. Samples were shipped from the sites to the Central Public Health Laboratory (CPHL) for temporary storage before transfer to the Uganda Virus Research Institute (UVRI) for genotyping. Prevalence of HIVDR among adults initiating or reinitiating ART was determined. RESULTS: Specimens from 491 participants (median age 32 years and 61.5% female) were collected between August and December 2016. Specimens from 351 participants were successfully genotyped. Forty-nine had drug resistance mutations, yielding an overall weighted HIVDR prevalence of 18.2% with the highest noted for NNRTIs at 14.1%. CONCLUSIONS: We observed a high HIVDR prevalence for NNRTIs among adults prior to initiating or reinitiating ART in Uganda. This is above WHO’s recommended threshold of 10% when countries should consider changing from NNRTI- to dolutegravir-based first-line regimens. This recommendation was adopted in the revised Ugandan ART guidelines. Dolutegravir-containing ART regimens are preferred for first- and second-line ART regimens. Oxford University Press 2021-05-15 /pmc/articles/PMC8361362/ /pubmed/33993252 http://dx.doi.org/10.1093/jac/dkab159 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Research Watera, Christine Ssemwanga, Deogratius Namayanja, Grace Asio, Juliet Lutalo, Tom Namale, Alice Sanyu, Grace Ssewanyana, Isaac Gonzalez-Salazar, Jesus Fidel Nazziwa, Jamirah Nanyonjo, Maria Raizes, Elliot Kabuga, Usher Mwangi, Christina Kirungi, Wilford Musinguzi, Joshua Mugagga, Kaggwa Mbidde, Edward Katongole Kaleebu, Pontiano HIV drug resistance among adults initiating antiretroviral therapy in Uganda |
title | HIV drug resistance among adults initiating antiretroviral therapy in Uganda |
title_full | HIV drug resistance among adults initiating antiretroviral therapy in Uganda |
title_fullStr | HIV drug resistance among adults initiating antiretroviral therapy in Uganda |
title_full_unstemmed | HIV drug resistance among adults initiating antiretroviral therapy in Uganda |
title_short | HIV drug resistance among adults initiating antiretroviral therapy in Uganda |
title_sort | hiv drug resistance among adults initiating antiretroviral therapy in uganda |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361362/ https://www.ncbi.nlm.nih.gov/pubmed/33993252 http://dx.doi.org/10.1093/jac/dkab159 |
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