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    Coronavirus Disease 2019 (COVID-19) Mitigation Efforts and Testing During an In-Person Training Event—Uganda, 12–29 October 2020

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    Coronavirus Disease 2019 (COVID-19) Mitigation Efforts and Testing During an In-Person Training Event—Uganda, 12–29 October 2020 (146.7Kb)
    Date
    2021
    Author
    Laws, Rebecca L.
    Biraro, Sam
    Kirungi, Wilford
    Gianetti, Brittany
    Aibo, Dorothy
    Awor, Anna C.
    West, Christine
    Sachathep, Karampreet K.
    Kiyingi, Herbert
    Ward, Jennifer
    Mwangi, Christina
    Nkurunziza, Peter
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    Abstract
    Viral load monitoring (VLM) to identify individuals failing antiretroviral therapy (ART) is not widely available in resource-limited settings. We compared the genotypic resistance patterns between clients with VLM versus immunological monitoring (IM).Between 2004–2008, 559 ART naïve clients were enrolled in a prospective cohort, initiated on ART, and monitored with viral load (VL) and CD4+ cell counts every 6 months (VLM group). From February 2008 through June 2009, 998 clients on ART for 36–40 months (corresponding to the follow-up time of the VLM group) at the same clinic and monitored with CD4+ cell counts every 6 months were recruited into a cross sectional study (IM group). Samples from VLM clients at 12, 24 and 36 months and IM clients at 36–40 months with VL > 2000 copies/ml underwent genotypic drug resistance testing.Baseline characteristics were similar. Virologic failure (VL > 400 copies/ml) at 12, 24 and 36 months in the VLM group were 12%, 6% and 8% respectively, and in the IM group 10% at 36–40 months. Samples from 39 VLM and 70 IM clients were genotyped. 23/39 (59%) clients in the VLM group (at 12, 24 or 36 months) compared to 63/70 (90%) in the IM group, (P < 0.0001) had at least 1 non-nucleoside reverse transcriptase mutation. 19/39 (49%) of VLM clients had an M184V mutation compared to 61/70 (87%) in the IM group (P < 0.0001). Only 2/39 (5%) of VLM clients developed thymidine analogue mutations compared to 34/70 (49%) of IM clients (P < 0.0001).Routine VL monitoring reduced the rate of accumulated genotypic resistance to commonly used ART in Uganda.
    URI
    https://nru.uncst.go.ug/xmlui/handle/123456789/2840
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    • Medical and Health Sciences [3670]

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