Low Primary and Secondary HIV Drug-Resistance after 12 Months of Antiretroviral Therapy in Human Immune-Deficiency Virus Type 1

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 Ki...

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Bibliographic Details
Published in:PloS one 2013-08, Vol.8 (8), p.e64345
Main Authors: Rusine, John, Asiimwe-Kateera, Brenda, van de Wijgert, Janneke, Boer, Kimberly Rachel, Mukantwali, Enatha, Karita, Etienne, Gasengayire, Agnes, Jurriaans, Suzanne, de Jong, Menno, Ondoa, Pascale
Format: Article
Language:English
Subjects:
Antiretroviral agents
Drug resistance
Drug therapy
Highly active antiretroviral therapy
HIV
Medical research
Patient compliance
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Summary: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[less than or equal to]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 [less than or equal to]200cell/[micro]l and severe CD4 depletion at baseline (
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0064345