High failure rates of protease inhibitor-based antiretroviral treatment in rural Tanzania – A prospective cohort study

• DOI: 10.1371/journal.pone.0227600
• Publication Date: 2020-01-13T13:30:05Z
• Authors: Rahel E. Bircher; Alex J. Ntamatungiro; Tracy R. Glass; Dorcas Mnzava; Amina Nyuri; Herry Mapesi; Daniel H. Paris; Manuel Battegay; Thomas Klimkait; Maja Weisser
• Keywords: Protease inhibitor (pharmacology); Antiretroviral treatment

Poor adherence to antiretroviral drugs and viral resistance are the main drivers of treatment failure in HIV-infected patients. In sub-Saharan Africa, avoidance on second-line protease inhibitor therapy is critical as options limited.In prospective observational study Kilombero & Ulanga Antiretroviral Cohort rural Tanzania, we assessed virologic (viral load ≥1,000 copies/mL) drug mutations bio-banked plasma samples 6-12 months after initiation a inhibitor-based regimen. Additionally, was measured before start inhibitor, second time between 1-5 years start, at suspected patients with available samples. We performed testing if ≥1000 copies/ml. Risk factors for were analyzed using logistic regression.In total, 252 included; those 56% female 21% children. Virologic occurred 26/199 (13.1%) adults 7/53 children (13.2%). The prevalence did not change over time. Nucleoside reverse transcriptase inhibitors mutation showed positive signal only 9/16 adults. No cases seen this taken demonstrated 2/7 adult nucleoside detected 30/41, non-nucleoside reverse-transcriptase 35/41 15/16 pediatric samples, both classes but present.Our confirms high early rates treated inhibitors, even absence mutations, suggesting an urgent need support setting.