scholarly journals Acquired HIV drug resistance among children and adults receiving antiretroviral therapy in Tanzania: a national representative survey protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e054021
Author(s):  
Joan Rugemalila ◽  
Doreen Kamori ◽  
Werner Maokola ◽  
Mucho Mizinduko ◽  
Godfrey Barabona ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Antiretroviral Therapy ◽  
National Survey ◽  
People Living With Hiv ◽  
Load Testing ◽  
Acquired Drug Resistance ◽  
Survey Report ◽  
Drug Resistance Genotyping ◽  
Ethical Approval ◽  
Survey Protocol

IntroductionTanzania is making an enormous effort in scaling-up of antiretroviral therapy (ART). However, people living with HIV (PLHIV) continue to succumb to the challenge of drug resistance. Evidence on drug resistance for a national survey is unavailable in Tanzania. Therefore, we sought to assess viral suppression (vs) rates and magnitude of acquired drug resistance (ADR) among PLHIV.Methods and analysisA national survey will be conducted from 26 July to 29 October 2021 in 22 regions, recruiting 2160 participants. These will include adults on ART for 9–15 months and ≥48 months and children on ART for 9–15 months and ≥36 months. A standardised questionnaire will capture participants’ demographic and clinical data. Plasma and dried blood spot will be prepared for viral load testing and drug resistance genotyping. Statistical analyses to determine the burden of ADR, characteristics and factors associated therewith will be done using STATA V.15.Ethics and disseminationEthical approval has been obtained from the National Health Research Ethics Committee of Tanzania (NIMR/HQ/R.8a/Vol.IX/3432). Appropriate participant informed consent or parental consent and assent will be obtained. Dissemination will include a survey report, conference presentations, policy briefs and peer-reviewed publications.

Emerging Trends in the Long-acting Antiretroviral Therapy: Current Status and Therapeutic Challenges

2020 ◽  
Vol 18 ◽  
Author(s):  
Rajpushpa Labh ◽  
Rachna Gupta
Keyword(s):  
Drug Resistance ◽  
Antiretroviral Therapy ◽  
Drug Distribution ◽  
Antiretroviral Drugs ◽  
Current Status ◽  
People Living With Hiv ◽  
Viral Reservoirs ◽  
Emerging Trends ◽  
Gradual Development ◽  
Long Acting

: Antiretroviral drug therapy has significantly improved the prognosis and life expectancy of People Living with HIV over the years. But this progress comes with an important caveat that antiretroviral regimens generally require adherence to life-long, daily dosing, to keep viral multiplication under check. Non-adherence to such dosing leads to decreased efficacy and increased drug resistance against antiretroviral drugs. Besides, poor drug penetration to certain tissues like CNS and lymph nodes leads to build-up of viral reservoirs in these sites. To combat some of these challenges and improve patient compliance, long-acting antiretroviral drugs, are a new weapon in the arsenal, in fight against HIV. Few long acting preparations have been approved, and several others are in various clinical and preclinical stages of development. However, longacting formulations also have their share of clinical issues like limited drug distribution, long term adverse drug reactions, drug-drug interactions, and gradual development of drug resistance. Modern technological premises are being tested to mitigate some of these problems. One such promising approach involves nanotechnological methods, which are being used to develop ultra-long acting formulations and drug delivery systems, targeting tissues with residual HIV concentration. LongActing Slow Effective Release Antiretroviral Therapy aka LASER ART, also builds on nanotechnology and prodrug modifications to design preparations with tailor-made favorable pharmacokinetics and wider drug distribution. These recent advances are fueling the progression of antiretroviral therapy towards eliminating the disease.

Evaluation of Acquired HIV Drug Resistance among People Living with HIV Who Have Taken Antiretroviral Therapy for 9–15 Months in 14 Triangular Clinics in Iran, 2015–2016

Intervirology ◽  
2018 ◽  
Vol 61 (6) ◽  
pp. 292-300 ◽  
Author(s):  
Minoo Mohraz ◽  
Katayoun Tayeri ◽  
Hengameh Namdari Tabar ◽  
Zahra Bayat Jozani ◽  
Leila Sadeghi ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Hiv Drug Resistance ◽  
Living With Hiv

scholarly journals High-Levels of Acquired Drug Resistance in Adult Patients Failing First-Line Antiretroviral Therapy in a Rural HIV Treatment Programme in KwaZulu-Natal, South Africa

PLoS ONE ◽  
2013 ◽  
Vol 8 (8) ◽  
pp. e72152 ◽  
Author(s):  
Justen Manasa ◽  
Richard J. Lessells ◽  
Andrew Skingsley ◽  
Kevindra K. Naidu ◽  
Marie-Louise Newell ◽  
...  
Keyword(s):  
South Africa ◽  
Drug Resistance ◽  
Antiretroviral Therapy ◽  
Hiv Treatment ◽  
Adult Patients ◽  
Treatment Programme ◽  
First Line ◽  
Acquired Drug Resistance ◽  
Kwazulu Natal

scholarly journals Virological failure among HIV infected individuals on antiretroviral therapy in Pune, India: a cross-sectional study

2021 ◽  
Vol 8 (8) ◽  
pp. 1193
Author(s):  
Pallavi Shidhaye ◽  
Nilima Lokhande ◽  
Smita Kulkarni ◽  
Shraddha Gurav ◽  
Pramod Deoraj ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Virological Failure ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Load Testing ◽  
First Line ◽  
Cross Sectional ◽  
Art Initiation ◽  
Adherence Counselling

Background: It is important to identify and manage determinants of virological failure among HIV infected individuals on treatment for achieving viral suppression. This study aimed to identify proportion and factors associated with virological failure among HIV infected individuals receiving first line antiretroviral therapy (ART).Methods: A total of 2670 adult HIV infected individuals attending ART centre at ICMR-National AIDS Research Institute, between January 2005 and June 2019 and having their recent viral load done after implementation of guidelines on routine viral load testing were included. Data were reviewed and analysed.Results: Of the 2670 people living with HIV (PLHIV) on first line antiretroviral therapy, 48% were male and 69% were more than 40 years of age. Mean baseline CD4 count at ART initiation was 252 cells/mm3 (SD:210, IQR 116-313) Overall, 13% (340/2670) of the participants showed virological failure. In multivariate analyses, participants with younger age and males retained significant association. Those with baseline CD4 counts of less than or equal to 500 cells/mm3 at treatment initiation (adjusted OR 1.71; 95% CI 1.08-2.70; p=0.022) and ART adherence ≤95% within last three months of recent viral load determination (adjusted OR 1.55, 95% CI of AOR 1.04-2.32; p=0.031) had higher risk for virological failure as compared to others. PLHIV with ART substitution due to various reasons were almost twice as likely to have virological failure (adjusted OR 1.83, 95% CI 1.44-2.33; p<0.001).Conclusions: It is crucial to focus on factors leading to virological failure among HIV infected individuals attending ART centre. Early linkage to treatment and ART initiation along with adherence counselling at every follow up visit play an important role in mitigating virological failure.

scholarly journals The use of dried blood spot specimens for HIV-1 drug resistance genotyping in young children initiating antiretroviral therapy

2015 ◽  
Vol 223 ◽  
pp. 30-32 ◽  
Author(s):  
Anna T. Salimo ◽  
Johanna Ledwaba ◽  
Ashraf Coovadia ◽  
Elaine J. Abrams ◽  
Karl-Günter Technau ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Antiretroviral Therapy ◽  
Young Children ◽  
Dried Blood Spot ◽  
Drug Resistance Genotyping ◽  
Hiv 1 ◽  
Blood Spot
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