ArticlePloS one2012
Monitoring HIV viral load in resource limited settings: still a matter of debate?
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Efavirenz: History, Development and Future.Biomolecules · 2022Review
- Evaluation of a health system intervention to improve virological management in an antiretroviral programme at a municipal clinic in central Durban.Southern African journal of HIV medicine · 2019Article
- Economic and public health impact of decentralized HIV viral load testing: A modelling study in Kenya.PloS one · 2019Article
- HIV virologic failure and its predictors among HIV-infected adults on antiretroviral therapy in the African Cohort Study.PloS one · 2019Article
- Article
- Low levels of viral suppression among refugees and host nationals accessing antiretroviral therapy in a Kenyan refugee camp.Conflict and health · 2017Article
- HIV virological failure and drug resistance in a cohort of Tanzanian HIV-infected adults.The Journal of antimicrobial chemotherapy · 2016Article
- Reading Out Single-Molecule Digital RNA and DNA Isothermal Amplification in Nanoliter Volumes with Unmodified Camera Phones.ACS nano · 2016Article
- Total Lymphocyte Count and Haemoglobin Concentration Combined as a Surrogate Marker for Initiating Highly Active Antiretroviral Therapy in a Resource-limited Setting as against CD4 Cell Count.The West Indian medical journal · 2014Article
- Short communication: prospective comparison of qualitative versus quantitative polymerase chain reaction for monitoring virologic treatment failure in HIV-infected patients.AIDS research and human retroviruses · 2014Article
- Prospective evaluation of diagnostic accuracy of dried blood spots from finger prick samples for determination of HIV-1 load with the NucliSENS Easy-Q HIV-1 version 2.0 assay in Malawi.Journal of clinical microbiology · 2014Article
- Developments in CD4 and viral load monitoring in resource-limited settings.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2014Review
- Immuno-haematologic and virologic responses and predictors of virologic failure in HIV-1 infected adults on first-line antiretroviral therapy in Cameroon.Infectious diseases of poverty · 2014Article
- Antiretroviral treatment outcome in HIV-1-infected patients routinely followed up in capital cities and remote areas of Senegal, Mali and Guinea-Conakry.Journal of the International AIDS Society · 2014Article
- Article
- Membrane-based, sedimentation-assisted plasma separator for point-of-care applications.Analytical chemistry · 2013Article
- Tracking the progress of HIV: the impact of point-of-care tests on antiretroviral therapy.Clinical epidemiology · 2013Review
- Translational HIV-1 research: from routine diagnostics to new virology insights in Amsterdam, the Netherlands during 1983-2013.Retrovirology · 2013Review
- Evaluation of WHO immunologic criteria for treatment failure: implications for detection of virologic failure, evolution of drug resistance and choice of second-line therapy in India.Journal of the International AIDS Society · 2013Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionConsequences of lack of viral monitoring in predicting the effects of development of HIV drug resistance mutations during HAART in resource-limited settings (RLS) is still a matter of debate.
designTo assess, among HIV+ patients receiving their first-line HAART, prevalence of virological failure and genotypic resistance mutations pattern in a Médécins Sans Frontières/Ministry of Health programme in Busia District (Kenya).
methodsPatients with HAART treatment for ≥12 months were eligible for the study and those with HIV-RNA ≥5000 copies/ml underwent genotypic study. Total HIV-1 RNA from Dried Blood Spots was extracted using Nuclisens method.
results926 patients were included. Among 274 (29.6%) patients with detectable viral load, 55 (5.9%) experienced treatment failure (viral load >5.000 copies/ml); 61.8% were female and 10 (18.2%) had clinical failure. Median CD4 cell count was 116 cell/mm3 (IQR: 54-189). Median HIV-RNA was 32,000 copies/ml (IQR: 11000-68000). Eighteen out of 55 (33%) samples could be sequenced on PR and RT genes, with resistance associated mutations (RAMs) in 15 out of 18 samples (83%). Among patients carrying RAMs, 12/15 (81%) harboured RAMs associated to thymidine analogues (TAMs). All of them (100%) showed M184V resistance associated mutation to lamivudine as well as NNRTI's RAMS.
conclusionsVirological failure rate in resource-limited settings are similar to those observed in developed countries. Resistance mutation patterns were concordant with HAART received by failing patients. Long term detectable viral load confers greater probability of developing resistance and as a consequence, making difficult to find out a cost-effective subsequent treatment regimen.
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