Viral load suppression and HIV-1 drug resistance mutations in persons with HIV on TLD/TAFED in Zambia

• Published in: PloS one 2024-09, Vol.19 (9), p.e0308869
• Main Authors: Luwaya, Emmanuel L, Mwape, Lackson, Bwalya, Kaole, Siakabanze, Chileleko, Hamooya, Benson M, Masenga, Sepiso K
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Anti-HIV Agents - pharmacology; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral therapy; Antiviral agents; Care and treatment; Confidence intervals; Cross-Sectional Studies; Data collection; Dosage and administration; Drug Combinations; Drug resistance; Drug Resistance, Viral - genetics; Electronic health records; Electronic medical records; Emtricitabine; Emtricitabine - therapeutic use; Epidemiology; Female; Females; GLP-1 receptor agonists; Heterocyclic Compounds, 3-Ring - pharmacology; Heterocyclic Compounds, 3-Ring - therapeutic use; HIV; HIV Infections - drug therapy; HIV Infections - virology; HIV patients; HIV-1 - drug effects; HIV-1 - genetics; Human immunodeficiency virus; Humans; Lamivudine; Lamivudine - pharmacology; Lamivudine - therapeutic use; Load resistance; Male; Measurement; Middle Aged; Mutation; Non-nucleoside reverse transcriptase inhibitors; Nucleoside reverse transcriptase inhibitors; Oxazines - therapeutic use; Piperazines - therapeutic use; Prevention; Pyridones - therapeutic use; Risk factors; RNA-directed DNA polymerase; Statistical analysis; Statistical methods; Switching; Tenofovir; Tenofovir - pharmacology; Tenofovir - therapeutic use; Viral Load - drug effects; Viremia; Young Adult; Zambia - epidemiology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0308869

An increase in the prevalence of HIV drug resistance (HIVDR) has been reported in recent years, especially in persons on non-nucleoside reverse transcriptase inhibitors (NNRTIs) due to their low genetic barrier to mutations. However, there is a paucity of epidemiological data quantifying HIVDR in the era of new drugs like dolutegravir (DTG) in sub-Saharan Africa. We, therefore, sought to determine the prevalence and correlates of viral load (VL) suppression in adult people with HIV (PWH) on a fixed-dose combination of tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD) or tenofovir alafenamide/emtricitabine/dolutegravir (TAFED) and describe patterns of mutations in individuals failing treatment. We conducted a cross-sectional study among 384 adults living with HIV aged ≥15 years between 5th June 2023 and 10th August 2023. Demographic, laboratory and clinical data were collected from electronic health records using a data collection form. Viral load suppression was defined as plasma HIV-1 RNA VL of