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DC Field | Value | Language |
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dc.contributor.author | Kantor, Rami | - |
dc.contributor.author | DeLong, Allison | - |
dc.contributor.author | Balamane, Maya | - |
dc.contributor.author | Schreier, Leeann | - |
dc.contributor.author | Lloyd, Robert M, Jr | - |
dc.contributor.author | Injera, Wilfred | - |
dc.contributor.author | Kamle, Lydia | - |
dc.contributor.author | Mambo, Fidelis | - |
dc.contributor.author | Muyonga, Sarah | - |
dc.contributor.author | Katzenstein, David | - |
dc.contributor.author | Hogan, Joseph | - |
dc.contributor.author | Buziba, Nathan | - |
dc.contributor.author | Diero, Lameck | - |
dc.date.accessioned | 2017-10-10T10:59:45Z | - |
dc.date.available | 2017-10-10T10:59:45Z | - |
dc.date.issued | 2014-11 | - |
dc.identifier.other | http://dx.doi.org/10.7448/IAS.17.1.19262 | - |
dc.identifier.uri | http://www.jiasociety.org/index.php/jias/article/view/19262 | - |
dc.identifier.uri | http://ir.mu.ac.ke:8080/xmlui/handle/123456789/190 | - |
dc.description.abstract | Introduction: Antiretroviral resistance leads to treatment failure and resistance transmission. Resistance data in western Kenya are limited. Collection of non-plasma analytes may provide additional resistance information. Methods: We assessed HIV diversity using the REGA tool, transmitted resistance by the WHO mutation list and acquired resistance upon first-line failure by the IAS_USA mutation list, at the Academic Model Providing Access to Healthcare (AMPATH), a major treatment programme in western Kenya. Plasma and four non-plasma analytes, dried blood-spots (DBS), dried plasmaspots (DPS), ViveSTTM-plasma (STP) and ViveST-blood (STB), were compared to identify diversity and evaluate sequence concordance. Results: Among 122 patients, 62 were treatment-naı¨ve and 60 treatment-experienced; 61% were female, median age 35 years, median CD4 182 cells/mL, median viral-load 4.6 log10 copies/mL. One hundred and ninety-six sequences were available for 107/122 (88%) patients, 58/62 (94%) treatment-naı¨ve and 49/60 (82%) treated; 100/122 (82%) plasma, 37/78 (47%) attempted DBS, 16/45 (36%) attempted DPS, 14/44 (32%) attempted STP from fresh plasma and 23/34 (68%) from frozen plasma, and 5/42 (12%) attempted STB. Plasma and DBS genotyping success increased at higher VL and shorter shipment-to-genotyping time. Main subtypes were A (62%), D (15%) and C (6%). Transmitted resistance was found in 1.8% of plasma sequences, and 7% combining analytes. Plasma resistance mutations were identified in 91% of treated patients, 76% NRTI, 91% NNRTI; 76% dual-class; 60% with intermediate-high predicted resistance to future treatment options; with novel mutation co-occurrence patterns. Nearly 88% of plasma mutations were identified in DBS, 89% in DPS and 94% in STP. Of 23 discordant mutations, 92% in plasma and 60% in non-plasma analytes were mixtures. Mean whole-sequence discordance from frozen plasma reference was 1.1% for plasma-DBS, 1.2% plasma-DPS, 2.0% plasma-STP and 2.3% plasma-STB. Of 23 plasma-STP discordances, one mutation was identified in plasma and 22 in STP (pB0.05). Discordance was inversely significantly related to VL for DBS. Conclusions: In a large treatment programme in western Kenya, we report high HIV-1 subtype diversity; low plasma transmitted resistance, increasing when multiple analytes were combined; and high-acquired resistance with unique mutation patterns. Resistance surveillance may be augmented by using non-plasma analytes for lower-cost genotyping in resource-limited settings. | en_US |
dc.description.sponsorship | This research was funded by a developmental grant from the Lifespan/Tufts/ Brown Center for AIDS Research, an NIH funded programme (P30AI42853); NIH grant R01AI066922, the Rhode Island Foundation and the Friendship Foundation. | en_US |
dc.language.iso | en | en_US |
dc.publisher | Journal of the International AIDS Society | en_US |
dc.relation.ispartofseries | ;Vol 17 (2014) | - |
dc.subject | HIV | en_US |
dc.subject | Drug | en_US |
dc.subject | Resistance | en_US |
dc.subject | Subtype | en_US |
dc.subject | Diversity | en_US |
dc.subject | Analyte | en_US |
dc.subject | AMPATH | en_US |
dc.subject | Kenya | en_US |
dc.title | HIV diversity and drug resistance from plasma and non-plasma analytes in a large treatment programme in western Kenya | en_US |
dc.type | Article | en_US |
Appears in Collections: | School of Medicine |
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