Pre-Treatment HIV Drug Resistance and Genetic Diversity in Cameroon: Implications for First-Line Regimens
Articolo
Data di Pubblicazione:
2023
Citazione:
Pre-Treatment HIV Drug Resistance and Genetic Diversity in Cameroon: Implications for First-Line Regimens / J. Fokam, C. Chenwi, V. Tala, D. Takou, M. Santoro, G. Teto, B. Dambaya, F. Anubodem, E. Ngoufack Jagni Semengue, G. Beloumou, S. Djupsa, E. Assomo, C. Fokunang, C. Alteri, S. Billong, N. Pamen Bouba, R. Ajeh, V. Colizzi, D. Mbanya, F. Ceccherini-Silberstein, C. Perno, A. Ndjolo. - In: VIRUSES. - ISSN 1999-4915. - 15:7(2023 Jun 28), pp. 1458.1-1458.10. [10.3390/v15071458]
Abstract:
The efficacy of first-line antiretroviral therapy (ART) may be hampered by the presence of HIV drug resistance (HIVDR). We described HIV-1 pre-treatment drug resistance (PDR) patterns, effect of viral clades on PDR, and programmatic implications on first-line regimens in Cameroon. A sentinel surveillance of PDR was conducted from 2014 to 2019. Sequencing of HIV-1 protease and reverse transcriptase was performed, and HIVDR was interpreted using Stanford HIVdb.v.9.4. In total, 379 sequences were obtained from participants (62% female, mean age 36 ± 10 years). The overall PDR rate was 15.0% [95% CI: 11.8-19.0] nationwide, with significant disparity between regions (p = 0.03). NNRTI PDR was highest (12.4%), of which 7.9% had DRMs to EFV/NVP. Two regions had EFV/NVP PDR above the 10% critical threshold, namely the Far North (15%) and East (10.9%). Eighteen viral strains were identified, predominated by CRF02_AG (65.4%), with no influence of genetic diversity PDR occurrence. TDF-3TC-DTG predictive efficacy was superior (98.4%) to TDF-3TC-EFV (92%), p < 0.0001. The overall high rate of PDR in Cameroon, not substantially affected by the wide HIV-1 genetic diversity, underscores the poor efficacy of EFV/NVP-based first-line ART nationwide, with major implications in two regions of the country. This supports the need for a rapid transition to NNRTI-sparing regimens, with TDF-3TC-DTG having optimal efficacy at the programmatic level.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Cameroon; HIV-1; first-line regimens; genetic diversity; pre-treatment drug resistance;
Elenco autori:
J. Fokam, C. Chenwi, V. Tala, D. Takou, M. Santoro, G. Teto, B. Dambaya, F. Anubodem, E. Ngoufack Jagni Semengue, G. Beloumou, S. Djupsa, E. Assomo, C. Fokunang, C. Alteri, S. Billong, N. Pamen Bouba, R. Ajeh, V. Colizzi, D. Mbanya, F. Ceccherini-Silberstein, C. Perno, A. Ndjolo
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