Predictive Factors of HIV-1 Drug Resistance and Its Distribution among Female Sex Workers in the Democratic Republic of the Congo (DRC).

Godefroid Mulakilwa Ali Musema,Takaisi Kikuni Ntonbo Za Balega,Paul-Samson Dikasa Lusamba,Désiré Tshala-Katumbay,Pierre Zalagile Akilimali

doi:10.3390/ijerph19042021

Abstract

The predictive factors of HIV-1 drug resistance and its distribution are poorly documented in female sex workers (FSWs) in the Democratic Republic of the Congo (DRC). However, the identification of predictive factors can lead to the development of improved and effective antiretroviral therapy (ART). The objective of the current study was to determine the predictive factors of HIV-1 drug resistance and its distribution based on FSWs in the studied regions in the Democratic Republic of the Congo (DRC). HIV-positive FSWs who were diagnosed as part of the DRC Integrated Biological and Behavioral Surveillance Survey (IBBS) were included in this study. A total of 325 FSWs participated. The HIV-1 viral load (VL) was measured according to the Abbott m2000sp and m2000rt protocols. The homogeneity chi-square test was conducted to determine the homogeneity of HIV-1 drug resistance distribution. Using a significance level of 0.05, multivariate analyses were performed to identify factors associated with HIV-1 drug resistance to ART. HIV drug resistance mutation (HIVDRM) distribution was homogeneous in the three study regions (p = 0.554) but differed based on the HIV-1 VLs of the FSWs. FSWs with high HIV-1 VLs harbored more HIVDRMs (p = 0.028) of predominantly pure HIV-1 strains compared with those that had low HIV-1 VLs. Sexually transmitted infection (STI) history (aOR [95%CI] = 8.51 [1.62, 44.74]), high HIV-1 VLs (aOR [95%CI] = 5.39 [1.09, 26.74]), and HIV-1–syphilis coinfection (aOR [95%CI] = 9.71 [1.84, 51.27]) were associated with HIV drug resistance among FSWs in the DRC. A history of STIs (e.g., abnormal fluid) in the 12 months prior to the survey, a high HIV-1 VL, and HIV-1–syphilis coinfection were associated with HIV-1 drug resistance among FSWs in the DRC. Efforts should be made to systematically test for other infections which increase the HIV-1 VL, in the case of HIV-1 coinfection, in order to maintain ART effectiveness across the DRC.

Highlights

To determine the sociodemographic characteristics of the human immunodeficiency virus (HIV)-positive female sex workers (FSWs) in the Democratic Republic of the Congo (DRC); To determine the prevalence of HIV drug resistance mutations (HIVDRMs) based on the HIV-1 viral load (VL) in FSWs in the DRC; To determine the HIVDRM distribution based on the study groups in the DRC; To identify the factors associated with HIVDRMs in FSWs in the DRC
HIV-1 Drug Resistance Mutations According to HIV-1 VL
We showed that HIV-positive FSWs in the DRC who had high HIV-1

Summary

Objectives

Objectives of the StudyThe overall objective of this study is to determine the predictive factors of HIV-1 drug resistance and its distribution according to the study groups in the DRC.1.3. The overall objective of this study is to determine the predictive factors of HIV-1 drug resistance and its distribution according to the study groups in the DRC. The specific objectives of this study are: To determine the sociodemographic characteristics of the HIV-positive FSWs in the DRC; To determine the prevalence of HIV drug resistance mutations (HIVDRMs) based on the HIV-1 VL in FSWs in the DRC; To determine the HIVDRM distribution based on the study groups in the DRC; To identify the factors associated with HIVDRMs in FSWs in the DRC

Methods

Results

Discussion

Conclusion