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Low primary and secondary HIV drug-resistance after 12 months of antiretroviral therapy in human immune-deficiency virus type 1 (HIV-1)-infected individuals from Kigali, Rwanda.

ABSTRACT: Treatment outcomes of HIV patients receiving antiretroviral therapy (ART) in Rwanda are scarcely documented. HIV viral load (VL) and HIV drug-resistance (HIVDR) outcomes at month 12 were determined in a prospective cohort study of antiretroviral-naïve HIV patients initiating first-line therapy in Kigali. Treatment response was monitored clinically and by regular CD4 counts and targeted HIV viral load (VL) to confirm drug failure. VL measurements and HIVDR genotyping were performed retrospectively on baseline and month 12 samples. One hundred and fifty-eight participants who completed their month 12 follow-up visit had VL data available at month 12. Most of them (88%) were virologically suppressed (VL?1000 copies/mL) but 18 had virological failure (11%), which is in the range of WHO-suggested targets for HIVDR prevention. If only CD4 criteria had been used to classify treatment response, 26% of the participants would have been misclassified as treatment failure. Pre-therapy HIVDR was documented in 4 of 109 participants (3.6%) with an HIVDR genotyping results at baseline. Eight of 12 participants (66.7%) with virological failure and HIVDR genotyping results at month 12 were found to harbor mutation(s), mostly NNRTI resistance mutations, whereas 4 patients had no HIVDR mutations. Almost half (44%) of the participants initiated ART at CD4 count ?200 cell/µl and severe CD4 depletion at baseline (<50 cells/µl) was associated with virological treatment failure (p?=?0.008). Although the findings may not be generalizable to all HIV patients in Rwanda, our data suggest that first-line ART regimen changes are currently not warranted. However, the accumulation of acquired HIVDR mutations in some participants underscores the need to reinforce HIVDR prevention strategies, such as increasing the availability and appropriate use of VL testing to monitor ART response, ensuring high quality adherence counseling, and promoting earlier identification of HIV patients and enrollment into HIV care and treatment programs.

SUBMITTER: Rusine J

PROVIDER: S-EPMC3741294 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Low primary and secondary HIV drug-resistance after 12 months of antiretroviral therapy in human immune-deficiency virus type 1 (HIV-1)-infected individuals from Kigali, Rwanda.

Rusine John J Asiimwe-Kateera Brenda B van de Wijgert Janneke J Boer Kimberly Rachel KR Mukantwali Enatha E Karita Etienne E Gasengayire Agnes A Jurriaans Suzanne S de Jong Menno M Ondoa Pascale P

PloS one 20130812 8

Treatment outcomes of HIV patients receiving antiretroviral therapy (ART) in Rwanda are scarcely documented. HIV viral load (VL) and HIV drug-resistance (HIVDR) outcomes at month 12 were determined in a prospective cohort study of antiretroviral-naïve HIV patients initiating first-line therapy in Kigali. Treatment response was monitored clinically and by regular CD4 counts and targeted HIV viral load (VL) to confirm drug failure. VL measurements and HIVDR genotyping were performed retrospectivel ...[more]

PMID: 23950859

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Project description:As with other countries globally, Rwanda has faced a recent outbreak of the coronavirus disease 2019 (COVID-19) against a backdrop of an HIV epidemic. At present, there is no successful cure or vaccine for both COVID-19 and HIV. People with underlying conditions, including HIV, are at increased risk of severe COVID-19 manifestations. This underscores the need to enhance the knowledge, attitudes, and practice of people living with HIV (PLWH) to protect this population against COVID-19. An institution-based cross-sectional study was conducted from August 31 to September 18, 2020 among 376 participants who were selected by a simple random sampling technique. A pretested and structured self-administered questionnaire was used to collect data. Quality scores were calculated as a measure of the participants' knowledge, attitudes, and practice (KAP) levels. The student t-test was used to compare continuous variables between low (<65%) and high (?65%) KAP scores. The chi-square test was used to determine the association between KAP scores and categorical variables. All decisions on statistical tests were concluded at 5% level of significance. All statistical analysis was performed using STATA statistical package version 11.2 (STATA Corp., Texas, USA). Of the 376 participants, 363 (97%) obtained a high knowledge score, while more than a quarter of the participants (26%) had a poor attitude score, and the majority (90%) having a high practice score. There was no association between gender, age, place of residence, employment, or duration on ART and knowledge score. Employment status and duration on antiretroviral treatment (ART) were significantly associated with attitude scores (p?=?0.004 and p?=?0.013, respectively). Gender and duration on ART were significantly associated with practice scores (p?=?0.02 and p?=?0.012, respectively). There was a moderate positive correlation (r?=?0.57) between knowledge and attitude scores, and knowledge and practice scores (r?=?0.55). There was a strong positive correlation (r?=?0.67) between attitude scores and practice scores. Health education programs tailored for PLWH and aimed at mobilizing and improving COVID-19-related knowledge, attitude, and practice should be prioritized in the Rwandan COVID-19 response.

Dataset Information

Low primary and secondary HIV drug-resistance after 12 months of antiretroviral therapy in human immune-deficiency virus type 1 (HIV-1)-infected individuals from Kigali, Rwanda.

Publications

Low primary and secondary HIV drug-resistance after 12 months of antiretroviral therapy in human immune-deficiency virus type 1 (HIV-1)-infected individuals from Kigali, Rwanda.

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