HIV-1 suppression and rare dolutegravir resistance in antiretroviral-experienced people with HIV in Liberia
Abstract Background Increasingly, persons with HIV in Liberia are receiving antiretroviral therapy containing the integrase strand-transfer inhibitor (InSTI) dolutegravir (DTG), but the prevalence of and factors associated with virologic failure and HIV drug resistance (HIVDR) remain unknown. Method...
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Nature Portfolio
2025-05-01
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| Series: | Communications Medicine |
| Online Access: | https://doi.org/10.1038/s43856-025-00875-x |
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| author | James Soka Moses Alice K. Pau Safia Kuriakose Greg Grandits Cavan Reilly Brad T. Sherman Weizhong Chang Lisheng Dai Muhammad A. Khan Helene Highbarger Moses Mannah Johnathan McCullough Carla Chorley Isaac Morlu Joseph Dorbor Ophelia Talweh Bongolee Rebecca Slewion Esther Akpa Barthalomew Wilson April L. Poole Stacy L. Kopka Tracey Miller Cecelia J. Nuta Christina Lindan David Glidden Jeffrey N. Martin Kumblytee L. Johnson Robin L. Dewar Ian Wachekwa Stephen A. Migueles |
| author_facet | James Soka Moses Alice K. Pau Safia Kuriakose Greg Grandits Cavan Reilly Brad T. Sherman Weizhong Chang Lisheng Dai Muhammad A. Khan Helene Highbarger Moses Mannah Johnathan McCullough Carla Chorley Isaac Morlu Joseph Dorbor Ophelia Talweh Bongolee Rebecca Slewion Esther Akpa Barthalomew Wilson April L. Poole Stacy L. Kopka Tracey Miller Cecelia J. Nuta Christina Lindan David Glidden Jeffrey N. Martin Kumblytee L. Johnson Robin L. Dewar Ian Wachekwa Stephen A. Migueles |
| author_sort | James Soka Moses |
| collection | DOAJ |
| description | Abstract Background Increasingly, persons with HIV in Liberia are receiving antiretroviral therapy containing the integrase strand-transfer inhibitor (InSTI) dolutegravir (DTG), but the prevalence of and factors associated with virologic failure and HIV drug resistance (HIVDR) remain unknown. Methods Cross-sectional analysis of 2019–2022 enrolment data from 1276 persons with HIV in the HONOR cohort included sociodemographic information, plasma viral loads (pVL), CD4 counts, and HIVDR testing by next generation sequencing in participants with virologic failure (pVL≥1000 copies/mL). Results Of the 1201 participants with pVL results, 72% are female and median age is 42 (interquartile range [IQR] 35–50) years. All are on ART (median 6.1 [2.1–11] years): 74% on DTG-based and 23% on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens. Ninety (7.5%) had virologic failure; 970 (81%) are suppressed (<40 copies/mL). Virologic failure is less prevalent with DTG- versus NNRTI-based regimens (5.3% vs. 14%, adjusted prevalence ratio [aPR]=0.3, 95% confidence interval [CI] 0.2–0.5) and is associated with age <50 years, CD4 count <200 cells/µL, and hemoglobin <11 g/dL. In 70 participants with virologic failure and successful sequencing, HIVDR prevalence is 81% for any ARV, 5.7% for InSTIs, 79% for NNRTIs, and 61% for nucleos(t)ide reverse transcriptase inhibitors (NRTIs). Intermediate-to-high resistance to ≥1 NRTI in current ART is less prevalent with DTG+2NRTIs than NNRTI+2NRTIs regimens (aPR = 0.5, 95%CI 0.3–0.8). Conclusions Most participants in the cohort are virologically-suppressed. Among those with virologic failure, HIVDR prevalence is high to NRTIs and NNRTIs, but low to InSTIs. Ongoing evaluation is necessary to determine the durability of DTG-based ART. |
| format | Article |
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| institution | OA Journals |
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| language | English |
| publishDate | 2025-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Communications Medicine |
| spelling | doaj-art-b18ed67aa3304acd8c8da8d519f7c9792025-08-20T02:15:16ZengNature PortfolioCommunications Medicine2730-664X2025-05-015111010.1038/s43856-025-00875-xHIV-1 suppression and rare dolutegravir resistance in antiretroviral-experienced people with HIV in LiberiaJames Soka Moses0Alice K. Pau1Safia Kuriakose2Greg Grandits3Cavan Reilly4Brad T. Sherman5Weizhong Chang6Lisheng Dai7Muhammad A. Khan8Helene Highbarger9Moses Mannah10Johnathan McCullough11Carla Chorley12Isaac Morlu13Joseph Dorbor14Ophelia Talweh Bongolee15Rebecca Slewion16Esther Akpa17Barthalomew Wilson18April L. Poole19Stacy L. Kopka20Tracey Miller21Cecelia J. Nuta22Christina Lindan23David Glidden24Jeffrey N. Martin25Kumblytee L. Johnson26Robin L. Dewar27Ian Wachekwa28Stephen A. Migueles29Partnership for Research on Vaccines & Infectious Diseases in Liberia (PREVAIL)National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)Clinical Research Directorate, Frederick National Laboratory for Cancer ResearchDivision of Biostatistics, School of Public health, University of MinnesotaDivision of Biostatistics, School of Public health, University of MinnesotaFrederick National Laboratory for Cancer ResearchFrederick National Laboratory for Cancer ResearchFrederick National Laboratory for Cancer ResearchFrederick National Laboratory for Cancer ResearchFrederick National Laboratory for Cancer ResearchPartnership for Research on Vaccines & Infectious Diseases in Liberia (PREVAIL)Advanced BioMedical Laboratories, LLCClinical Monitoring Research Program Directorate (CMRPD), Frederick National Laboratory for Cancer ResearchPartnership for Research on Vaccines & Infectious Diseases in Liberia (PREVAIL)Partnership for Research on Vaccines & Infectious Diseases in Liberia (PREVAIL)Partnership for Research on Vaccines & Infectious Diseases in Liberia (PREVAIL)Partnership for Research on Vaccines & Infectious Diseases in Liberia (PREVAIL)Clinical Monitoring Research Program Directorate (CMRPD), Frederick National Laboratory for Cancer ResearchPartnership for Research on Vaccines & Infectious Diseases in Liberia (PREVAIL)National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)Clinical Monitoring Research Program Directorate (CMRPD), Frederick National Laboratory for Cancer ResearchClinical Monitoring Research Program Directorate (CMRPD), Frederick National Laboratory for Cancer ResearchJohn F. Kennedy Medical CenterUniversity of California San FranciscoUniversity of California San FranciscoUniversity of California San FranciscoPartnership for Research on Vaccines & Infectious Diseases in Liberia (PREVAIL)Frederick National Laboratory for Cancer ResearchPartnership for Research on Vaccines & Infectious Diseases in Liberia (PREVAIL)National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)Abstract Background Increasingly, persons with HIV in Liberia are receiving antiretroviral therapy containing the integrase strand-transfer inhibitor (InSTI) dolutegravir (DTG), but the prevalence of and factors associated with virologic failure and HIV drug resistance (HIVDR) remain unknown. Methods Cross-sectional analysis of 2019–2022 enrolment data from 1276 persons with HIV in the HONOR cohort included sociodemographic information, plasma viral loads (pVL), CD4 counts, and HIVDR testing by next generation sequencing in participants with virologic failure (pVL≥1000 copies/mL). Results Of the 1201 participants with pVL results, 72% are female and median age is 42 (interquartile range [IQR] 35–50) years. All are on ART (median 6.1 [2.1–11] years): 74% on DTG-based and 23% on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens. Ninety (7.5%) had virologic failure; 970 (81%) are suppressed (<40 copies/mL). Virologic failure is less prevalent with DTG- versus NNRTI-based regimens (5.3% vs. 14%, adjusted prevalence ratio [aPR]=0.3, 95% confidence interval [CI] 0.2–0.5) and is associated with age <50 years, CD4 count <200 cells/µL, and hemoglobin <11 g/dL. In 70 participants with virologic failure and successful sequencing, HIVDR prevalence is 81% for any ARV, 5.7% for InSTIs, 79% for NNRTIs, and 61% for nucleos(t)ide reverse transcriptase inhibitors (NRTIs). Intermediate-to-high resistance to ≥1 NRTI in current ART is less prevalent with DTG+2NRTIs than NNRTI+2NRTIs regimens (aPR = 0.5, 95%CI 0.3–0.8). Conclusions Most participants in the cohort are virologically-suppressed. Among those with virologic failure, HIVDR prevalence is high to NRTIs and NNRTIs, but low to InSTIs. Ongoing evaluation is necessary to determine the durability of DTG-based ART.https://doi.org/10.1038/s43856-025-00875-x |
| spellingShingle | James Soka Moses Alice K. Pau Safia Kuriakose Greg Grandits Cavan Reilly Brad T. Sherman Weizhong Chang Lisheng Dai Muhammad A. Khan Helene Highbarger Moses Mannah Johnathan McCullough Carla Chorley Isaac Morlu Joseph Dorbor Ophelia Talweh Bongolee Rebecca Slewion Esther Akpa Barthalomew Wilson April L. Poole Stacy L. Kopka Tracey Miller Cecelia J. Nuta Christina Lindan David Glidden Jeffrey N. Martin Kumblytee L. Johnson Robin L. Dewar Ian Wachekwa Stephen A. Migueles HIV-1 suppression and rare dolutegravir resistance in antiretroviral-experienced people with HIV in Liberia Communications Medicine |
| title | HIV-1 suppression and rare dolutegravir resistance in antiretroviral-experienced people with HIV in Liberia |
| title_full | HIV-1 suppression and rare dolutegravir resistance in antiretroviral-experienced people with HIV in Liberia |
| title_fullStr | HIV-1 suppression and rare dolutegravir resistance in antiretroviral-experienced people with HIV in Liberia |
| title_full_unstemmed | HIV-1 suppression and rare dolutegravir resistance in antiretroviral-experienced people with HIV in Liberia |
| title_short | HIV-1 suppression and rare dolutegravir resistance in antiretroviral-experienced people with HIV in Liberia |
| title_sort | hiv 1 suppression and rare dolutegravir resistance in antiretroviral experienced people with hiv in liberia |
| url | https://doi.org/10.1038/s43856-025-00875-x |
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