HIV Drug Resistance Profile in Clients Experiencing Treatment Failure After the Transition to a Dolutegravir-Based First-Line Antiretroviral Treatment Regimen in Mozambique
Real-world data on HIV drug resistance (HIVDR) after transitioning to tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD) are limited. We assessed HIVDR rates and patterns in clients with virological failure (VF) after switching from an NNRTI-based regimen to TLD. A cross-sectional study was...
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MDPI AG
2025-01-01
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| author | Nalia Ismael Cidia Hussein Cacildo Magul Humberto Inguane Aleny Couto Amancio Nhangave Ana Muteerwa Mahoudo Bonou Artur Ramos Peter Wesley Young Sonia Chilundo Rhoderick Machekano Lauren Greenberg Juliana da Silva Nilesh Bhatt |
| author_facet | Nalia Ismael Cidia Hussein Cacildo Magul Humberto Inguane Aleny Couto Amancio Nhangave Ana Muteerwa Mahoudo Bonou Artur Ramos Peter Wesley Young Sonia Chilundo Rhoderick Machekano Lauren Greenberg Juliana da Silva Nilesh Bhatt |
| author_sort | Nalia Ismael |
| collection | DOAJ |
| description | Real-world data on HIV drug resistance (HIVDR) after transitioning to tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD) are limited. We assessed HIVDR rates and patterns in clients with virological failure (VF) after switching from an NNRTI-based regimen to TLD. A cross-sectional study was conducted in Gaza, Mozambique (August 2021–February 2022), including adults on first-line ART for ≥12 months who transitioned to TLD and had unsuppressed viral load (VL) ≥ 1000 copies/mL six months post-transition. After three adherence counseling sessions, participants with VF underwent genotyping for drug resistance mutations (DRMs) using the Stanford HIVdb Program. Of 717 participants (median age 39.2 years, 70.7% female), 217 (30.2%) had VF, 193 (88.9%) underwent genotyping, with 183 (94.8%) successfully genotyped. Intermediate–high dolutegravir (DTG) resistance was found in 19.6% (36/183). Unsuppressed VL before DTG transition was independently associated with VF (aOR: 2.14). Resistance patterns included 33.3% (12/36; 95% CI: 14.6–46.3) to all three TLD drugs, 55.6% (20/36; 95% CI: 39.3–71.9) to DTG and 3TC, and 11% (4/36; 95% CI: 0.8–21.3) to DTG only. Major drug resistance mutations to DTG included G118R (9.3%), R263K (6.6%), and Q148H/R/K (4.4%). This study highlights the need to consider virologic status before transitioning PLHIV to TLD and suggests that adherence counseling may not prevent resistance in those with unknown or prior VF. |
| format | Article |
| id | doaj-art-7ce3f032172849fb98fbf20eb906afb8 |
| institution | Kabale University |
| issn | 2076-0817 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
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| series | Pathogens |
| spelling | doaj-art-7ce3f032172849fb98fbf20eb906afb82025-01-24T13:44:43ZengMDPI AGPathogens2076-08172025-01-011414810.3390/pathogens14010048HIV Drug Resistance Profile in Clients Experiencing Treatment Failure After the Transition to a Dolutegravir-Based First-Line Antiretroviral Treatment Regimen in MozambiqueNalia Ismael0Cidia Hussein1Cacildo Magul2Humberto Inguane3Aleny Couto4Amancio Nhangave5Ana Muteerwa6Mahoudo Bonou7Artur Ramos8Peter Wesley Young9Sonia Chilundo10Rhoderick Machekano11Lauren Greenberg12Juliana da Silva13Nilesh Bhatt14Instituto Nacional de Saúde, Estrada Nacional N1, Marracuene 3943, MozambiqueElizabeth Glaser Pediatric AIDS Foundation, Avenida Paulo Samuel KanKhomba, 280 Bairro da Sommerschield, Maputo 20005, MozambiqueInstituto Nacional de Saúde, Estrada Nacional N1, Marracuene 3943, MozambiqueElizabeth Glaser Pediatric AIDS Foundation, Avenida Paulo Samuel KanKhomba, 280 Bairro da Sommerschield, Maputo 20005, MozambiqueNational HIV and STI Control Program, Ministry of Health, Salvador Allende 1008, Maputo 1101, MozambiqueOperational Research Unit, Gaza Provincial Health Directorate, Rua do Hospital Provincial, 33 Bairro 13, Cidade de Xai-Xai 1200, MozambiqueDivision of Global HIV & TB, U.S. Centers for Diseases Control and Prevention, Avenida Marginal 5467, Maputo 1101, MozambiqueElizabeth Glaser Pediatric AIDS Foundation, Avenida Paulo Samuel KanKhomba, 280 Bairro da Sommerschield, Maputo 20005, MozambiqueDivision of Global HIV & TB, U.S. Centers for Diseases Control and Prevention, Avenida Marginal 5467, Maputo 1101, MozambiqueDivision of Global HIV & TB, U.S. Centers for Diseases Control and Prevention, Avenida Marginal 5467, Maputo 1101, MozambiqueDivision of Global HIV & TB, U.S. Centers for Diseases Control and Prevention, Avenida Marginal 5467, Maputo 1101, MozambiqueElizabeth Glaser Pediatric AIDS Foundation, Washington, DC 20005, USAElizabeth Glaser Pediatric AIDS Foundation, Washington, DC 20005, USADivision of Global HIV & TB, U.S. Centers for Diseases Control and Prevention, Atlanta, GA 30333, USAElizabeth Glaser Pediatric AIDS Foundation, Washington, DC 20005, USAReal-world data on HIV drug resistance (HIVDR) after transitioning to tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD) are limited. We assessed HIVDR rates and patterns in clients with virological failure (VF) after switching from an NNRTI-based regimen to TLD. A cross-sectional study was conducted in Gaza, Mozambique (August 2021–February 2022), including adults on first-line ART for ≥12 months who transitioned to TLD and had unsuppressed viral load (VL) ≥ 1000 copies/mL six months post-transition. After three adherence counseling sessions, participants with VF underwent genotyping for drug resistance mutations (DRMs) using the Stanford HIVdb Program. Of 717 participants (median age 39.2 years, 70.7% female), 217 (30.2%) had VF, 193 (88.9%) underwent genotyping, with 183 (94.8%) successfully genotyped. Intermediate–high dolutegravir (DTG) resistance was found in 19.6% (36/183). Unsuppressed VL before DTG transition was independently associated with VF (aOR: 2.14). Resistance patterns included 33.3% (12/36; 95% CI: 14.6–46.3) to all three TLD drugs, 55.6% (20/36; 95% CI: 39.3–71.9) to DTG and 3TC, and 11% (4/36; 95% CI: 0.8–21.3) to DTG only. Major drug resistance mutations to DTG included G118R (9.3%), R263K (6.6%), and Q148H/R/K (4.4%). This study highlights the need to consider virologic status before transitioning PLHIV to TLD and suggests that adherence counseling may not prevent resistance in those with unknown or prior VF.https://www.mdpi.com/2076-0817/14/1/48HIVdrug resistancedolutegravirMozambique |
| spellingShingle | Nalia Ismael Cidia Hussein Cacildo Magul Humberto Inguane Aleny Couto Amancio Nhangave Ana Muteerwa Mahoudo Bonou Artur Ramos Peter Wesley Young Sonia Chilundo Rhoderick Machekano Lauren Greenberg Juliana da Silva Nilesh Bhatt HIV Drug Resistance Profile in Clients Experiencing Treatment Failure After the Transition to a Dolutegravir-Based First-Line Antiretroviral Treatment Regimen in Mozambique Pathogens HIV drug resistance dolutegravir Mozambique |
| title | HIV Drug Resistance Profile in Clients Experiencing Treatment Failure After the Transition to a Dolutegravir-Based First-Line Antiretroviral Treatment Regimen in Mozambique |
| title_full | HIV Drug Resistance Profile in Clients Experiencing Treatment Failure After the Transition to a Dolutegravir-Based First-Line Antiretroviral Treatment Regimen in Mozambique |
| title_fullStr | HIV Drug Resistance Profile in Clients Experiencing Treatment Failure After the Transition to a Dolutegravir-Based First-Line Antiretroviral Treatment Regimen in Mozambique |
| title_full_unstemmed | HIV Drug Resistance Profile in Clients Experiencing Treatment Failure After the Transition to a Dolutegravir-Based First-Line Antiretroviral Treatment Regimen in Mozambique |
| title_short | HIV Drug Resistance Profile in Clients Experiencing Treatment Failure After the Transition to a Dolutegravir-Based First-Line Antiretroviral Treatment Regimen in Mozambique |
| title_sort | hiv drug resistance profile in clients experiencing treatment failure after the transition to a dolutegravir based first line antiretroviral treatment regimen in mozambique |
| topic | HIV drug resistance dolutegravir Mozambique |
| url | https://www.mdpi.com/2076-0817/14/1/48 |
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