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

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. ART-naive, HIV-1...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2016-07, Vol.71 (7), p.1966-1974
Main Authors: Hawkins, Claudia, Ulenga, Nzovu, Liu, Enju, Aboud, Said, Mugusi, Ferdinand, Chalamilla, Guerino, Sando, David, Aris, Eric, Carpenter, Deborah, Fawzi, Wafaie
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Anti-HIV Agents - pharmacology
Anti-HIV Agents - therapeutic use
Antiretroviral drugs
Drug resistance
Drug Resistance, Viral
Female
HIV
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV Infections - virology
Human immunodeficiency virus
Humans
Incidence
Male
Middle Aged
Mutation
Randomized Controlled Trials as Topic
Retrospective Studies
Tanzania - epidemiology
Treatment Failure
Virology
Young Adult
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Summary: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. 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. 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+ T cell count (P = 0.01) and non-adherence to ART (P 
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/dkw051