Effectiveness of antiretroviral therapy and development of drug resistance in HIV-1 infected patients in Mombasa, Kenya

With increasing numbers of people gaining access to antiretroviral therapy (ART) in resource limited...

With increasing numbers of people gaining access to antiretroviral therapy (ART) in resource limited settings, there will also be increasing numbers of virologic failure and drug resistance occurring. The aim of this study was to assess, in a cross-sectional survey, the rate of viral suppression and drug resistance among individuals receiving ART. The study was conducted among patients attending the Comprehensive HIV Care Centre (CCC) of Coast Province General Hospital, Mombasa, Kenya. One hundred and fifty HIV-infected individuals receiving ART, were consecutively recruited to participate in the study. Their viral load was measured and those with detectable levels had genotypic drug resistance testing. Of the 150 participants 132 had been on ART for more than 6 months. Nineteen patients had a detectable viral load and 16 were successfully sequenced for protease (PR) and reverse transcriptase (RT) genes. No major PR mutations were found, but mutations associated with drug resistance in RT were detected in 14 of the 16 patients (87.5%). The 3TC mutation M184V and the NNRTI mutation K103N were most frequent. Overall the results of the study showed a high rate of treatment success after short term ART in patients treated at a public provincial hospital in a resource limited setting. However, the high risk of accumulation of resistance mutations among patients failing treatment and the selection of multi-drug resistance mutations remains a concern for future treatment options and potential transmission to partners.

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