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@article{Bareng:2022:jac/dkac056,
author = {Bareng, OT and Moyo, S and Zahralban-Steele, M and Maruapula, D and Ditlhako, T and Mokaleng, B and Mokgethi, P and Choga, WT and Moraka, NO and Pretorius-Holme, M and Mine, MO and Raizes, E and Molebatsi, K and Motswaledi, MS and Gobe, I and Mohammed, T and Gaolathe, T and Shapiro, R and Mmalane, M and Makhema, JM and Lockman, S and Essex, M and Novitsky, V and Gaseitsiwe, S},
doi = {jac/dkac056},
journal = {Journal of Antimicrobial Chemotherapy},
pages = {1385--1395},
title = {HIV-1 drug resistance mutations among individuals with low-level viraemia while taking combination ART in Botswana},
url = {http://dx.doi.org/10.1093/jac/dkac056},
volume = {77},
year = {2022}
}

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TY  - JOUR
AB  - ObjectivesTo assess whether a single instance of low-level viraemia (LLV) is associated with the presence of drug resistance mutations (DRMs) and predicts subsequent virological failure (VF) in adults receiving ART in 30 communities participating in the Botswana Combination Prevention Project.MethodsA total of 6078 HIV-1 C pol sequences were generated and analysed using the Stanford HIV drug resistance database. LLV was defined as plasma VL = 51–999copies/mL and VF was defined as plasma VL ≥ 1000copies/mL.ResultsAmong 6078 people with HIV (PWH), 4443 (73%) were on ART for at least 6months. Of the 332 persons on ART with VL > 50copies/mL, 175 (4%) had VL ≥ 1000copies/mL and 157 (4%) had LLV at baseline. The prevalence of any DRM was 57 (36%) and 78 (45%) in persons with LLV and VL ≥ 1000copies/mL, respectively. Major DRMs were found in 31 (20%) with LLV and 53 (30%) with VL ≥ 1000copies/mL (P = 0.04). Among the 135 PWH with at least one DRM, 17% had NRTI-, 35% NNRTI-, 6% PI- and 3% INSTI-associated mutations. Among the 3596 participants who were followed up, 1709 (48%) were on ART for ≥6months at entry and had at least one subsequent VL measurement (median 29months), 43 (3%) of whom had LLV. The OR of experiencing VF in persons with LLV at entry was 36-fold higher than in the virally suppressed group.ConclusionsA single LLV measurement while on ART strongly predicted the risk of future VF, suggesting the use of VL > 50copies/mL as an indication for more intensive adherence support with more frequent VL monitoring.
AU  - Bareng,OT
AU  - Moyo,S
AU  - Zahralban-Steele,M
AU  - Maruapula,D
AU  - Ditlhako,T
AU  - Mokaleng,B
AU  - Mokgethi,P
AU  - Choga,WT
AU  - Moraka,NO
AU  - Pretorius-Holme,M
AU  - Mine,MO
AU  - Raizes,E
AU  - Molebatsi,K
AU  - Motswaledi,MS
AU  - Gobe,I
AU  - Mohammed,T
AU  - Gaolathe,T
AU  - Shapiro,R
AU  - Mmalane,M
AU  - Makhema,JM
AU  - Lockman,S
AU  - Essex,M
AU  - Novitsky,V
AU  - Gaseitsiwe,S
DO  - jac/dkac056
EP  - 1395
PY  - 2022///
SN  - 0305-7453
SP  - 1385
TI  - HIV-1 drug resistance mutations among individuals with low-level viraemia while taking combination ART in Botswana
T2  - Journal of Antimicrobial Chemotherapy
UR  - http://dx.doi.org/10.1093/jac/dkac056
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000762455100001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
UR  - https://academic.oup.com/jac/article/77/5/1385/6539949
VL  - 77
ER  -

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