A Retrospective Survey of HIV Drug Resistance among Patients One Year after Initiation of Antiretroviral Therapy at Four Clinics in Malawi

HIV & AIDS, Infectious Diseases,
Journal Articles

A Retrospective Survey of HIV Drug Resistance among Patients One Year after Initiation of Antiretroviral Therapy at Four Clinics in Malawi

By: Nellie Wadonda-Kabondo, Bethany L. Hedt, Joep J. van Oosterhout, Kundai Moyo, Eddie Limbambala, George Bello, Ben Chilima, Erik Schouten, Anthony Harries, Moses Massaquoi, Carol Porter, Ralf Weigel, Mina Hosseinipour, John Aberle-Grasse, Michael R. Jordan, Storn Kabuluzi, Diane E. Bennett
Publication: Clinical Infectious Diseases54 (4) (May 2012). doi:10.1093/cid/cis004.

Abstract

In 2004, Malawi began scaling up its national antiretroviral therapy (ART) program. Because of limited treatment options, population-level surveillance of acquired human immunodeficiency virus drug resistance (HIVDR) is critical to ensuring long-term treatment success. The World Health Organization target for clinic-level HIVDR prevention at 12 months after ART initiation is ≥70%. In 2007, viral load and HIVDR genotyping was performed in a retrospective cohort of 596 patients at 4 ART clinics. Overall, HIVDR prevention (using viral load ≤400 copies/mL) was 72% (95% confidence interval [CI], 67%–77%; range by site, 60%–83%) and detected HIVDR was 3.4% (95% CI, 1.8%–5.8%; range by site, 2.5%–4.7%). Results demonstrate virological suppression and HIVDR consistent with previous reports from sub-Saharan Africa. High rates of attrition because of loss to follow-up were noted and merit attention.

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