Abstract
IntroductionAntiretroviral therapy plays a major role in reducing the impact of Human Immunodeficiency Virus/Acquired Immune Disease Syndrome, especially in resource-limited settings. However, without proper infrastructure, it has resulted in emergence of drug resistance mutations in infected populations. To determine drug resistance mutations among patients attending a comprehensive care facility in Nairobi, 65 blood samples were successfully sequenced.MethodsWhole blood samples were also tested for CD4+T-cell count and plasma HIV-1 RNA Viral load. Drug-resistance testing targeting the HIV-1 RT gene was determined. Patients were on first line ART that consisted of two NRTIs, and one NNRTI.ResultsFemales were younger (mean 42) than males (mean 45) and lower median CD4+ counts (139 cells/μl) than males (152 cells/μl). The prevalence of drug resistance mutations (any major mutation) in this population was 23.1% (15/65). Major NRTI mutations were detected in 11 patient samples, which included M184V (n = 6), M41L (n=3), D67N (n=2), K219Q (n=3) and T215F (n=2). Major NNRTI mutations were detected in 14 patient samples. They included K103N (n = 10), G190A (n = 1), Y181C (n = 1) and Y188L (n = 1).ConclusionPresence of major mutations in this study calls for proper laboratory infrastructure to monitor treatment as well as regular appraisals of available regimens.
Highlights
Antiretroviral therapy plays a major role in reducing the impact of Human Immunodeficiency Virus/Acquired Immune Disease Syndrome, especially in resource-limited settings
There is a concern that antiretroviral drug resistance among those on treatment would spread to those acquiring new infections and compromise the current regimens thereby giving rise to early treatment failure among those on Antiretroviral Therapy (ART)
The most prevalent NNRTI mutation that was detected in the studied population was K103N, which is associated with the use of Nevirapine – a major component of first line regimens in Kenya
Summary
Antiretroviral therapy plays a major role in reducing the impact of Human Immunodeficiency Virus/Acquired Immune Disease Syndrome, especially in resource-limited settings. This study was carried out with the aim of establishing the prevalence of drug resistance mutations among HIV antiretroviral drugs are limited in Kenya and only those meeting some criteria can receive treatment. This study was carried out with the aim of establishing the prevalence of drug resistance mutations among HIV-1 infected patients seeking care and treatment from an established government comprehensive care center of Kenyatta National hospital in 2009. This data would assist in better care and service provision to patients so as to improve HIV prevention initiatives for targeted resource allocation and service delivery among the infected
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