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

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 th...

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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
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container_title PloS one
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creator Luwaya, Emmanuel L
Mwape, Lackson
Bwalya, Kaole
Siakabanze, Chileleko
Hamooya, Benson M
Masenga, Sepiso K
description 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
doi_str_mv 10.1371/journal.pone.0308869
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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 &lt;1000 copies/ml after being on ART for ≥ 6 months. SPSS version 22 to analyze the data. Descriptive statistics and logistic regression were the statistical methods used. The median (interquartile range (IQR)) age was 22 (IQR 18, 38) years, and 66.1% (n = 254) were females. VL suppression was 90.4% (n = 347); (95% confidence interval (CI) 87.6%-93.6%) after switching to TLD/TAFED. Among the virally suppressed, the majority (67.1%, n = 233) were female. Those who missed ≥2 doses in the last 30 days prior to the most recent review were less likely to attain viral suppression compared to those who did not miss any dose (adjusted odds ratio (AOR) 0.047; 95% CI 0.016-0.136; p&lt;0.001). Four participants had resistance mutations to lamivudine and tenofovir. The most common NRTI mutations were M184MV and K65R while K101E was the most common NNRTI mutation. Our findings show that viral suppression was high after switching to TLD/TAFED; but lower than the last 95% target of the UNAIDS. Adherence to antiretroviral therapy was a significant correlate of VL suppression. 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genetics</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Lamivudine</topic><topic>Lamivudine - pharmacology</topic><topic>Lamivudine - therapeutic use</topic><topic>Load resistance</topic><topic>Male</topic><topic>Measurement</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Non-nucleoside reverse transcriptase inhibitors</topic><topic>Nucleoside reverse transcriptase inhibitors</topic><topic>Oxazines - therapeutic use</topic><topic>Piperazines - therapeutic use</topic><topic>Prevention</topic><topic>Pyridones - therapeutic use</topic><topic>Risk factors</topic><topic>RNA-directed DNA polymerase</topic><topic>Statistical analysis</topic><topic>Statistical methods</topic><topic>Switching</topic><topic>Tenofovir</topic><topic>Tenofovir - pharmacology</topic><topic>Tenofovir - therapeutic use</topic><topic>Viral Load - drug effects</topic><topic>Viremia</topic><topic>Young Adult</topic><topic>Zambia - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Luwaya, Emmanuel L</creatorcontrib><creatorcontrib>Mwape, Lackson</creatorcontrib><creatorcontrib>Bwalya, Kaole</creatorcontrib><creatorcontrib>Siakabanze, Chileleko</creatorcontrib><creatorcontrib>Hamooya, Benson M</creatorcontrib><creatorcontrib>Masenga, Sepiso K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological &amp; Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science &amp; Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies &amp; Aerospace Collection</collection><collection>Agricultural &amp; Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Meteorological &amp; Geoastrophysical Abstracts - 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Academic</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Luwaya, Emmanuel L</au><au>Mwape, Lackson</au><au>Bwalya, Kaole</au><au>Siakabanze, Chileleko</au><au>Hamooya, Benson M</au><au>Masenga, Sepiso K</au><au>Kapaata, Anne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Viral load suppression and HIV-1 drug resistance mutations in persons with HIV on TLD/TAFED in Zambia</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-09-06</date><risdate>2024</risdate><volume>19</volume><issue>9</issue><spage>e0308869</spage><pages>e0308869-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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 &lt;1000 copies/ml after being on ART for ≥ 6 months. SPSS version 22 to analyze the data. Descriptive statistics and logistic regression were the statistical methods used. The median (interquartile range (IQR)) age was 22 (IQR 18, 38) years, and 66.1% (n = 254) were females. VL suppression was 90.4% (n = 347); (95% confidence interval (CI) 87.6%-93.6%) after switching to TLD/TAFED. Among the virally suppressed, the majority (67.1%, n = 233) were female. Those who missed ≥2 doses in the last 30 days prior to the most recent review were less likely to attain viral suppression compared to those who did not miss any dose (adjusted odds ratio (AOR) 0.047; 95% CI 0.016-0.136; p&lt;0.001). Four participants had resistance mutations to lamivudine and tenofovir. The most common NRTI mutations were M184MV and K65R while K101E was the most common NNRTI mutation. Our findings show that viral suppression was high after switching to TLD/TAFED; but lower than the last 95% target of the UNAIDS. Adherence to antiretroviral therapy was a significant correlate of VL suppression. We, therefore, recommend prompt switching of PWH to TLD/TAFED regimen and close monitoring to enhance adherence to therapy.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>39241081</pmid><doi>10.1371/journal.pone.0308869</doi><tpages>e0308869</tpages><orcidid>https://orcid.org/0000-0001-9518-2422</orcidid><orcidid>https://orcid.org/0009-0007-1924-6819</orcidid><oa>free_for_read</oa></addata></record>
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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
title Viral load suppression and HIV-1 drug resistance mutations in persons with HIV on TLD/TAFED in Zambia
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