Development of HIV Drug Resistance in a Cohort of Adults on First-Line Antiretroviral Therapy in Tanzania during the Stavudine Era

Microbiology Research

Perpétua Gómes¹  Eligius F. Lyamuya²  Eric Van Wijngaerden³  Ricardo J. Camacho⁴  Anne-Mieke Vandamme⁴  Fausta Mosha⁴  Raphael Z. Sangeda⁵  Soo-Yon Rhee⁶ 

[1] Centro Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Caparica, Portugal;Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania;Department of Microbiology, Immunology and Transplantation and University Hospitals, KU Leuven, 3000 Leuven, Belgium;Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven-University of Leuven, 3000 Leuven, Belgium;Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania;Division of Infectious Diseases, Stanford University, Stanford, CA 94305, USA;

关键词: HIV-1;    drug resistance;    Dar es Salaam;    Tanzania;    NNRTI;    NRTI;   

DOI  :  10.3390/microbiolres12040062

来源: DOAJ

【 摘 要 】

As more HIV patients start combination antiretroviral therapy (cART), the emergence of HIV drug resistance (HIVDR) is inevitable. This will have consequences for the transmission of HIVDR, the success of ART, and the nature and trend of the epidemic. We recruited a cohort of 223 patients starting or continuing their first-line cART in Tanzania towards the end of the stavudine era in 2010. Patients were then followed for one year. Of those with a viral load test at baseline and follow-up time, 34% had a detectable viral load at the one-year endpoint. For 41 patients, protease and reverse transcriptase genotyping were successful. Eighteen samples were from cART-naïve patients, and 23 samples were taken under therapy either at baseline for cART-experienced patients or from follow-up samples for both cART–naïve and cART–experienced patients. The isolates were subtype A, followed by C and D in 41.5%, 22%, and 12.2% of the patients, respectively. No transmitted HIVDR was detected, as scored using the surveillance drug resistance mutations (DRMs) list. However, in 3 of the 18 samples from cART-naïve patients, the clinical Rega interpretation algorithm scored 44D or 138A as non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance-associated polymorphisms. The most observed nucleoside reverse transcriptase inhibitor (NRTI) mutation was 184V. The mutation was found in 16 patients, causing resistance to lamivudine and emtricitabine. Nineteen patients had NNRTI resistance mutations, the most common of which was 103N, observed in eight patients. These high levels of resistance call for regular drug resistance surveillance in Tanzania to inform the control of the emergence and transmission of HIVDR.

【 授权许可】

Unknown