HIV virologic failure & drug resistance

HIV-related illnesses and deaths are on the decline in sub-Saharan Africa as increasing numbers of people get on and stay on antiretroviral therapy (ART). Treatment failure and drug resistance can undermine these gains. We recruited adults on ART at a rural HIV clinic in Coastal Kenya to assess risk factors for treatment failure and drug resistance. A quarter (24.6%) of 232 adults who had been on ART for an average of 14 months had treatment failure. Half of adults with treatment failure (52.7%) had acquired resistance to one or more of the drugs that they were on, while 47.3% had no detectable drug resistance. Younger age, poor adherence to treatment, and high viral load counts were associated with treatment failure and drug resistance. These sobering findings call for youth-friendly ART initiatives and strengthened adherence support. Further, HIV drug resistance testing for patients with confirmed treatment failure can prevent unnecessary/premature switches.


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