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Determinants of virological failure and antiretroviral drug resistance in Mozambique

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dc.contributor Universitat de Vic - Universitat Central de Catalunya. Càtedra de la Sida i Malalties Relacionades
dc.contributor.author Rupérez, María
dc.contributor.author Pou, Christian
dc.contributor.author Maculuve, Sonia
dc.contributor.author Cedeño, Samandhy
dc.contributor.author Luis, Leopoldina
dc.contributor.author Rodríguez, Judith
dc.contributor.author Letang, Emilio
dc.contributor.author Moltó, José
dc.contributor.author Macete, Eusébio
dc.contributor.author Clotet, Bonaventura
dc.contributor.author Alonso, Pedro
dc.contributor.author Menéndez, Clara
dc.contributor.author Naniche, Denise
dc.contributor.author Paredes, Roger
dc.date.accessioned 2015-11-18T12:26:10Z
dc.date.available 2015-11-18T12:26:10Z
dc.date.created 2015
dc.date.issued 2015
dc.identifier.citation Ruperez, M., Pou, C., Maculuve, S., Cedeno, S., Luis, L., Rodriguez, J., et al. (2015). Determinants of virological failure and antiretroviral drug resistance in mozambique. Journal of Antimicrobial Chemotherapy, 70(9), 2639-2647. ca_ES
dc.identifier.issn 1460-2091
dc.identifier.uri http://hdl.handle.net/10854/4362
dc.description.abstract Objectives: The objective of this study was to inform public health actions to limit first-line ART failure and HIV drug resistance in Mozambique. Methods: This was a cross-sectional study. HIV-1-infected adults on first-line ART for at least 1 year attending routine visits in the Manhic¸a District Hospital, in a semi-rural area in southern Mozambique with no HIV-1 RNA monitoring available, were evaluated for clinical, socio-demographic, therapeutic, immunological and virological characteristics. Factors associated with HIV-1 RNA ≥1000 copies/mL and HIV drug resistance were determined using multivariate logistic regression. Results: The study included 334 adults on first-line ART for a median of 3 years, of which 65% (214/332) had suppressed viraemia, 11% (37/332) had low-level viraemia (HIV-1 RNA 150–999 copies/mL) and 24% (81/332) had overt virological failure (HIV-1 RNA ≥1000 copies/mL). HIV drug resistance was detected in 89% of subjects with virological failure, but in none with low-level viraemia. Younger age [OR¼0.97 per additional year (95% CI¼0.94–1.00), P¼0.039], ART initiation at WHO stage III/IV [OR¼2.10 (95% CI¼1.23–3.57), P¼0.003] and low ART adherence [OR¼2.69 (95% CI¼1.39–5.19), P¼0.003] were associated with virological failure. Longer time on ART [OR¼1.55 per additional year (95% CI¼1.00–2.43), P¼0.052] and illiteracy [OR¼0.24 (95% CI¼0.07–0.89), P¼0.033] were associated with HIV drug resistance. Compared with HIV-1 RNA, clinician’s judgement of ART failure, based on clinical and immunological outcomes, only achieved 29% sensitivity and misdiagnosed 1 out of every 4.5 subjects. Conclusions: Public health programmes in Mozambique should focus on early HIV diagnosis, early ART initiation and adherence support. Virological monitoring drastically improves the diagnosis of ART failure, enabling a better use of resources. ca_ES
dc.format application/pdf
dc.format.extent 9 p. ca_ES
dc.language.iso eng ca_ES
dc.publisher Oxford University Press ca_ES
dc.rights Tots els drets reservats ca_ES
dc.rights (c) Oxford University Press
dc.subject.other Sida -- Tractament ca_ES
dc.subject.other VIH (Virus) ca_ES
dc.title Determinants of virological failure and antiretroviral drug resistance in Mozambique ca_ES
dc.type info:eu-repo/semantics/article ca_ES
dc.identifier.doi https://doi.org/10.1093/jac/dkv143
dc.rights.accessRights info:eu-repo/semantics/closedAccess ca_ES
dc.type.version info:eu-repo/publishedVersion ca_ES
dc.indexacio Indexat a WOS/JCR ca_ES
dc.indexacio Indexat a SCOPUS

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