Rates Of HIV-1 Virological Suppression And Patterns Of Acquired Drug Resistance Among Fisherfolk On First-Line Antiretroviral Therapy In Uganda

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dc.contributor.authorOmooja, Jonah
dc.contributor.authorNannyonjo, Maria
dc.contributor.authorSanyu, Grace
dc.contributor.authorNabirye, Stella E.
dc.contributor.authorNassolo, Faridah
dc.contributor.authorLunkuse, Sandra
dc.contributor.authorKapaata, Anne
dc.contributor.authorSegujja, Farouk
dc.contributor.authorKateete, David Patrick
dc.contributor.authorSsebaggala, Eric
dc.contributor.authorBbosa, Nicholas
dc.contributor.authorAling, Emmanuel
dc.contributor.authorNsubuga, Rebecca N.
dc.contributor.authorKaleebu, Pontiano
dc.contributor.authorSsemwanga, Deogratius
dc.date.accessioned2022-02-17T19:40:28Z
dc.date.available2022-02-17T19:40:28Z
dc.date.issued2019
dc.description.abstractWe examined virological outcomes, patterns of acquired HIV drug resistance (ADR), correlates of virological failure (VF) and acquired drug resistance among fisherfolk on first-line ART.We enrolled 1169 adults on ART for a median duration of 6, 12, 24, 36 and ≥48 months and used a pooled VL testing approach to identify VF (VL ≥1000 copies/mL). We performed genotyping among VF cases and determined correlates of VF and ADR by logistic regression.The overall virological suppression rate was 91.7% and ADR was detected in 71/97 (73.2%) VF cases. The most prevalent mutations were M184V/I (53.6%) for NRTIs and K103N (39.2%) for NNRTIs. Thymidine analogue mutations were detected in 21.6% of VF cases while PI mutations were absent. A zidovudine-based ART regimen, duration on ART (≥24 months) and secondary/higher education level were significantly associated with VF. A nevirapine-based regimen [adjusted OR (aOR): 1.87; 95% CI: 0.03–0.54)] and VL ≥10000 copies/mL (aOR: 3.48; 95% CI: 1.37–8.85) were ADR correlates. The pooling strategies for VL testing with a negative predictive value (NPV) of ≥95.2% saved US $20320 (43.5%) in VL testing costs.We observed high virological suppression rates among these highly mobile fisherfolk; however, there was widespread ADR among those with VF at the first VL testing prior to intensive adherence counselling. Timely treatment switching and adherence support is recommended for better treatment outcomes. Adoption of pooled VL testing could be cost effective, particularly in resource-limited settings.en_US
dc.identifier.citationOmooja, J., Nannyonjo, M., Sanyu, G., Nabirye, S. E., Nassolo, F., Lunkuse, S., ... & Ssemwanga, D. (2019). Rates of HIV-1 virological suppression and patterns of acquired drug resistance among fisherfolk on first-line antiretroviral therapy in Uganda. Journal of Antimicrobial Chemotherapy, 74(10), 3021-3029.https://doi.org/10.1093/jac/dkz261en_US
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/2178
dc.language.isoenen_US
dc.publisherJournal of Antimicrobial Chemotherapyen_US
dc.subjectmutation, drug resistance, adult, hiv-1, nevirapine, uganda, zidovudine, virology, anti-retroviral agents, nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitorsen_US
dc.titleRates Of HIV-1 Virological Suppression And Patterns Of Acquired Drug Resistance Among Fisherfolk On First-Line Antiretroviral Therapy In Ugandaen_US
dc.typeArticleen_US
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