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Prevalence of HIV drug resistance in Nigeria: results from a cross-sectional, population-based survey of Nigerian adults with unsuppressed viral load
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2 01 2023
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Source: AIDS. 37(2):333-339
Details:
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Alternative Title:AIDS
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Personal Author:
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Description:Background
HIV drug resistance (HIVDR) surveillance is an important tool to monitor threats to progress towards epidemic control. The characterization of HIVDR in Nigeria at the national level is needed to inform both clinical decisions and population-level HIV policy strategies. This study uses data obtained from the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) to describe the prevalence and distribution of HIVDR in Nigeria.
Methods
NAIIS was a cross-sectional, population-based survey of households throughout Nigeria in 2018. NAIIS was designed to provide estimates of HIV prevalence and related health indicators from a nationally representative sample. The study population included participants aged 15–64 years who tested positive for HIV, had a viral load ≥1,000 copies/ml, and had available HIV drug-resistance genotypes. HIV isolates were genotyped to detect drug resistance mutations. Individual characteristics of study participants associated with HIVDR were identified using a weighted multivariable logistic regression model.
Results
Of 1355 respondents with available HIV genotypes, 293 (19%) had evidence of drug-resistant mutations (DRMs) that conferred resistance to ≥1 antiretroviral drugs. The majority of DRMs observed conferred resistance to NNRTIs (17.6%) and NRTIs (11.2%). HIVDR was associated with being ART experienced, longer duration on ART, and lower CD4 count, but not sociodemographic characteristics.
Conclusions
The population level DRM prevalence in Nigeria was consistent with what would be expected in a mature HIV treatment landscape. The continued roll out of dolutegravir anchored regimens should mitigate the impact of NNRTI resistance on population viral load suppression and progress towards epidemic control.
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Pubmed ID:36541644
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Pubmed Central ID:PMC11167453
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