Prevalence and characteristics of HIV drug resistance among antiretroviral treatment (ART) experienced adolescents and young adults living with HIV in Ndola, Zambia

摘要: Background HIV drug resistance (HIVDR) poses a threat to the epidemic control in Zambia especially sub-populations such as 15-24 years where there is poor virological suppression. Understanding prevalence and patterns of HIVDR this population (15-24 years) will contribute defining effective antiretroviral therapy (ART) regimens, improving clinical decision making, supporting behavioral change interventions needed achieve control. Methods A cross-sectional analysis study enrollment data from Project YES! Youth Engaging for Success randomized controlled trial was conducted. Participants were 15 24 old, who knew their status, had been on ART at least 6 months. All participants completed survey underwent viral load (VL) testing. with failure (VL ≥1,000 copies/mL) testing which included mutations protease reverse transcriptase genes. Results total 99 out 273 analyzed receiving VL failure, whom 77 successful amplification analysis. Out 77, 75% (58) one resistant mutation, among 83% (48/58) required change. Among 58 mutations, mutation nucleoside inhibitors (NRTIs), non-nucleoside (NNRTIs) (PIs) 81%, 65.5% 1.7%. The M184V confers NRTI drugs lamivudine (3TC) emtricitabine (FTC) most common (81%) associated followed by K65R (34.5%) both tenofovir disoproxil fumarate (TDF) alafenamide (TAF) resistance. Thymidine analogue (TAMs) confer primarily zidovudine (AZT), stavudine (d4T) other NRTIs observed 32.8%. Common TAMs K70RTQNE (32.8%), K219QE (22.4%), D67N (17.2%) T215IT (15.5%). NNRTI K103N (65.5%) efavirenz (EFV) nevirapine (NVP). There relatively high occurrence V106A (36.2%), well Y188C (36.2%) Y181C etravirine. Conclusions including despite majority these patients (90.48%) being AZT or d4T sparing first line youth. Emergence (Y181C Y188C) may compromise future second- third-line regimens absence routine monitoring start first-line can better inform making programing.