Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Tanzania Field Epidemiology and Laboratory Training Program, Dar es Salaam, Tanzania.
HIV Res Clin Pract. 2024 Dec;25(1):2400827. doi: 10.1080/25787489.2024.2400827. Epub 2024 Sep 8.
Resistance to antiretrovirals against human immunodeficiency virus (HIV) poses a threat to zero transmission of HIV by 2030. Few studies have been conducted on HIV drug resistance (HIVDR) mutations targeting adolescents. We determined the prevalence, pattern of HIVDR mutations, and factors associated with unsuppressed HIV viral load among adolescents on antiretroviral therapy (ART).
From March to June 2020, we conducted a cross-sectional study at the Infectious Disease Clinic in Dar es Salaam, Tanzania. HIV-1 viral load was tested using m2000rt Real-Time HIV-1 assay. A sample with a viral load equal or more than 1,000 copies/ml was tested for HIVDR mutations. We determined the factors associated with unsuppressed viral load using logistic regression. A -value less than 0.05 was considered significant.
We enrolled 131 participants with a median age (interquartile range) of 15 (13-18) years. Of all, 24(18.3%) had a viral load above 1000 copies/ml. HIVDR mutations were found in 19/24(68.4%). Mutation to protease inhibitors, nucleotide reverse transcriptase inhibitors, and non-nucleoside reverse transcriptase inhibitors were 1(5.2%), 9(47.4%), and 11(57.9%), respectively. Non-antiretroviral therapy and orphanages were independently associated with unsuppressed viral load.
The prevalence of HIVDR and unsuppressed HIV viral load among adolescents are relatively high. The use of non-antiretroviral therapy and orphanage influenced the persistence of high viral load. Strategies for surveillance of HIVDR early warning signs should be devised among adolescents.
人类免疫缺陷病毒 (HIV) 的抗药性对 2030 年实现 HIV 零传播构成威胁。针对青少年的 HIV 耐药性 (HIVDR) 突变研究较少。我们旨在确定接受抗逆转录病毒治疗 (ART) 的青少年中 HIVDR 突变的流行率、模式以及与未抑制 HIV 病毒载量相关的因素。
2020 年 3 月至 6 月，我们在坦桑尼亚达累斯萨拉姆传染病诊所进行了一项横断面研究。使用 m2000rt 实时 HIV-1 测定法检测 HIV-1 病毒载量。病毒载量等于或超过 1000 拷贝/ml 的样本进行 HIVDR 突变检测。我们使用逻辑回归确定与未抑制病毒载量相关的因素。 - 值小于 0.05 被认为具有统计学意义。
我们共纳入了 131 名参与者，中位年龄（四分位距）为 15 岁（13-18 岁）。其中，24 名（18.3%）的病毒载量超过 1000 拷贝/ml。在 24 名患者中，发现了 19 名（68.4%）有 HIVDR 突变。蛋白酶抑制剂、核苷酸逆转录酶抑制剂和非核苷酸逆转录酶抑制剂的突变分别为 1 名（5.2%）、9 名（47.4%）和 11 名（57.9%）。未接受抗逆转录病毒治疗和孤儿院是与未抑制病毒载量相关的独立因素。
青少年中 HIVDR 和未抑制 HIV 病毒载量的流行率相对较高。未接受抗逆转录病毒治疗和孤儿院的使用影响了高病毒载量的持续存在。应制定针对青少年 HIVDR 早期预警信号的监测策略。
