HIV-1 Drug Resistance Mutations in Patients Failing 1st Line Therapy in a Comprehensive Care Center in Nairobi, Kenya ()
ABSTRACT
Background: HIV-1 drug resistance is an
emerging challenge for HIV-1 infected clients who are on antiretroviral therapy
(ART). In Kenya, as in many other developing countries, ART is now accesible
to clients who need it. However, they must be done a CD4 test first and if the
count is <300, then ART is commenced. With the initiation of ART comes the
challenge of adherence to medication, a factor that is impacted greatly by the
understanding of the client of the importance of adherence and the
financial ability to keep their appointments, especially if the clients come
from a distant location. Objective: To identify HIV-1 drug resistance mutations
inclientsfailing1st line antiretroviral therapy in Nairobi, Kenya. Methodology:
A cross sectional study was carried out where whole blood samples were
collected from clients attending a HIV care and treatment clinic in Nairobi.
Clients who had been on ART for more than 6 months and had a viral load greater
than 1000 were enrolled in the study. A total of 52 client samples were
successfully sequenced in the reverse transcriptase region and analyzed.
Results: After analysis of the generated sequences, it was seen that 43 (82.6%)
of the clients had HIV-1 drug resistance mutations conferring resistance to one
or more nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside
reverse-transcriptase inhibitors (NNRTIs). Majority of the clients (46%) were
infected with HIV-1 subtype A viruses. Conclusion: The findings of the study
showed that a significant proportion of the clients on ART had developed
resistance mutations to one or more drugs that are used as 1st line therapy in
Kenya. There is need for continuous education of the population on importance
of adherence to medication. There is also need for clinicians to be trained on
using viral load and HIV drug resistance testing, where available, as methods
of monitoring treatment failure so that clients can be switched to alternative
medication immediately the need arises, so as to improve their treatment outcomes.
Share and Cite:
Luvai, E. , Waihenya, R. , Munyao, J. , Sanguli, L. , Mwachari, C. and Khamadi, S. (2015) HIV-1 Drug Resistance Mutations in Patients Failing 1st Line Therapy in a Comprehensive Care Center in Nairobi, Kenya.
World Journal of AIDS,
5, 83-89. doi:
10.4236/wja.2015.52010.
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