Details

Autor(en) / Beteiligte

• Deuba, Keshab
• Panta, Gopal
• Rajbhandari, Rajesh Man
• Kunwar, Rajyashree
• Pokhrel, Tara Nath
• Pandey, Lok Raj
• Changsom, Don
• Saeng-aroon, Siriphan
• Thakur, Sanjay Kumar

Titel

Prevalence of viral load suppression and acquired drug resistance among people living with HIV in Nepal: a nationally representative surveillance study

Ist Teil von

• Journal of global antimicrobial resistance., 2023-12, Vol.35, p.122-127

Ort / Verlag

Netherlands: Elsevier Ltd

Erscheinungsjahr

2023

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •First data on acquired HIV drug resistance in Nepal's PLHIV reveal high prevalence.•High NNRTI resistance in ART failure highlights need for enhanced treatment switch.•Prioritize routine monitoring of early warning indicators of HIV drug resistance. This is the first nationally representative study to estimate the prevalence of viral load (VL) suppression and acquired HIV drug resistance (ADR) among people living with HIV (PLHIV) in Nepal. A cross-sectional study recruited 1418 PLHIV from 20 ART centres in Nepal, using a two-stage cluster design. Participants were eligible if they were HIV-positive individuals on ART for 9–15 months or at least 48 months. Plasma specimens were collected and tested for the quantification of HIV-1 RNA. Specimens with a VL ≥1000 copies/mL were further processed for sequencing of PR and RT genes of HIV-1. The sequences were then analysed to detect mutations causing HIV drug resistance. The prevalence of ADR was 3.7% (95% confidence interval [CI]: 1.8–7.6) and 3.0% (95% CI: 1.8–5.2) among PLHIV who received ART for 9–15 months and 48 months or more, respectively. The prevalence of VL suppression was 95.3% (95% CI: 91.7–97.4) among those on ART for 9–15 months, and 96.5% (95% CI: 94.7–97.7) among those on ART for at least 48 months. The prevalence of any detectable acquired resistance to antiretroviral drugs was 80.7% (95% CI: 58.6–92.5) among those on ART for 9–15 months with VL ≥1000 copies/mL and 81.6% (95% CI: 55.4–94.0) among those on ART for at least 48 months with VL ≥1000 copies/mL. This study suggests that improved accessibility to VL monitoring and timely assessment of drug resistance in routine HIV programs are crucial in Nepal to ensure access to HIV treatment for all in need.