Namale, Gertrude, Kamacooko, Onesmus, Bagiire, Daniel et al. (12 more authors) (2019) Sustained virological response and drug resistance among female sex workers living with HIV on antiretroviral therapy in Kampala, Uganda:a cross-sectional study. Sexually Transmitted Infections. pp. 405-411. ISSN 1368-4973
Abstract
OBJECTIVES: We assessed the prevalence and risk factors associated with virological failure among female sex workers living with HIV on antiretroviral therapy (ART) in Kampala, Uganda. METHODS: We conducted a cross-sectional study between January 2015 and December 2016 using routinely collected data at a research clinic providing services to women at high risk of STIs including HIV. Plasma samples were tested for viral load from HIV-seropositive women aged ≥18 years who had been on ART for at least 6 months and had received adherence counselling. Samples from women with virological failure (≥1000 copies/mL) were tested for HIV drug resistance by population-based sequencing. We used logistic regression to identify factors associated with virological failure. RESULTS: Of 584 women, 432 (74%) with a mean age of 32 (SD 6.5) were assessed, and 38 (9%) were found to have virological failure. HIV resistance testing was available for 78% (28/38), of whom 82.1% (23/28) had at least one major drug resistance mutation (DRM), most frequently M184V (70%, 16/23) and K103N (65%, 15/23). In multivariable analysis, virological failure was associated with participant age 18-24 (adjusted OR (aOR)=5.3, 95% CI 1.6 to 17.9), self-reported ART non-adherence (aOR=2.6, 95% CI 1.2 to 5.8) and baseline CD4+ T-cell count ≤350 cells/mm3 (aOR=3.1, 95% CI 1.4 to 7.0). CONCLUSIONS: A relatively low prevalence of virological failure but high rate of DRM was found in this population at high risk of transmission. Younger age, self-reported ART non-adherence and low CD4+ T-cell count on ART initiation were associated with increased risk of virological failure.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. |
Keywords: | Antiretroviral therapy (art),Drug resistance mutation,Female sex workers,HIV,Virological failure,Virological suppression |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York |
Depositing User: | Pure (York) |
Date Deposited: | 23 Jul 2019 15:00 |
Last Modified: | 16 Oct 2024 15:53 |
Published Version: | https://doi.org/10.1136/sextrans-2018-053854 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1136/sextrans-2018-053854 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:148920 |
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