HIV‑1 protease inhibitor drug resistance in Kenyan antiretroviral treatment‑naive and ‑experienced injection drug users and non‑drug users

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Date
2015
Authors
Budambula, Valentine
Musumba, Francis O.
Webale, Mark K.
Kahiga, Titus M.
Ongecha‑Owuor, Francisca
Kiarie, James N.
Sowayi, George A.
Ahmed, Aabid A.
Ouma, Collins
Were, Tom
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: Although injection drug use drives antiretroviral drug resistance, the prevalence of protease inhibitor (PI) resistance among Kenyan IDUs remains undetermined. We, therefore, explored PI resistance mutations and their association with viral load and CD4+ T cell counts in HIV-1 infected IDUs (ART-naive, n = 32; and -experienced, n = 47) and non-drug users (ART-naive, n = 21; and -experienced, n = 32) naive for PI treatment from coastal Kenya. Results: Only IDUs harboured major PI resistance mutations consisting of L90M, M46I and D30 N among 3 (6.4 %) ART-experienced and 1 (3.1 %) -naive individuals. Minor PI mutations including A71T, G48E, G48R, I13V, K20I, K20R, L10I, L10V, L33F, L63P, T74S, V11I, and V32L were detected among the ART-experienced (36.2 vs. 46.9 %) and -naive (43.8 vs. 66.7 %) IDUs and non-drug users, respectively. All the four IDUs possessing major mutations had high viral load while three presented with CD4+ T cell counts of <500 cells/ml. Among the ART-naive non-drug users, CD4+ T cell counts were significantly lower in carriers of minor mutations compared to non-carriers (P < 0.05). Conclusion: Transmitted drug resistance may occur in IDUs underscoring the need for genotyping resistance before initiating PI treatment.
Description
Research paper
Keywords
HIV-1, Protease inhibitor, Drug resistance, Antiretroviral, Treatment-naive, Treatment-experienced, Injection drug users, Non-drug users, Coastal Kenya
Citation
Budambula et al. AIDS Res Ther (2015) 12:27 DOI 10.1186/s12981-015-0070-y