Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
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
_version_ 1783737943108616192
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
work_keys_str_mv AT waterachristine hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT ssemwangadeogratius hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT namayanjagrace hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT asiojuliet hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT lutalotom hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT namalealice hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT sanyugrace hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT ssewanyanaisaac hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT gonzalezsalazarjesusfidel hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT nazziwajamirah hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT nanyonjomaria hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT raizeselliot hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT kabugausher hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT mwangichristina hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT kirungiwilford hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT musinguzijoshua hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT mugaggakaggwa hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT mbiddeedwardkatongole hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda
AT kaleebupontiano hivdrugresistanceamongadultsinitiatingantiretroviraltherapyinuganda