HIV virological failure and drug resistance in a cohort of Tanzanian HIV-infected adults

Claudia Hawkins*, Nzovu Ulenga, Enju Liu, Said Aboud, Ferdinand Mugusi, Guerino Chalamilla, David Sando, Eric Aris, Deborah Carpenter, Wafaie Fawzi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Objectives: There are few data on ART failure rates and drug resistance from Tanzania, where there is a wide diversity of non-B HIV subtypes. We assessed rates and predictors of virological failure in HIV-infected Tanzanians and describe drug resistance patterns in a subgroup of these patients. Methods: ART-naive, HIV-1-infected adults enrolled in a randomized controlled trial between November 2006 and 2008 and on ≥24 weeks of first-line NNRTI-containing ART were included. Population-based genotyping of HIV-1 protease and reverse transcriptase was performed on stored plasma from patients with virological failure (viral load > 1000 copies/mL at ≥24 weeks of ART) and at baseline, where available. Results: A total of 2403 patients [median (IQR) age 37 (32-43) years; 70% female] were studied. The median (IQR) baseline CD4+ T cell count was 128 (62-190) cells/μL. Predominant HIV subtypes were A, C and D (92.2%). The overall rate of virological failure was 14.9% (95% CI 13.2%-16.1%). In adjusted analyses, significant predictors of virological failure were lower CD4+Tcell count (P=0.01) and non-adherence to ART (P < 0.01). Drug resistance mutations were present in 87/115 samples (75.7%); the most common were M184V/I (52.2%) and K103N (35%). Thymidine analogue mutations were uncommon (5.2%). The prevalence of mutations in 45 samples pre- ART was 22%. Conclusions: High levels of early ART failure and drug resistance were observed among Tanzanian HIV-1-infected adults enrolled in awell-monitored study. Initiating treatment early and ensuring optimal adherence are vital for the success and durability of first-line ART in these settings.

Original languageEnglish (US)
Pages (from-to)1966-1974
Number of pages9
JournalJournal of Antimicrobial Chemotherapy
Volume71
Issue number7
DOIs
StatePublished - Jul 2016

ASJC Scopus subject areas

  • Pharmacology
  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

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