CROI in Boston with Ragna, Cissy & Sonia

From 20 – 25 February, the  Conference on Retroviruses and Opportunistic Infections (CROI) and CROI-affiliated International HIV Drug Resistance Workshop (RW) will take place in Boston, USA. AIGHD is sending three PhD students from the PASER-MARCH network to these conferences: Ragna Boerma, Cissy Kityo and Sonia Boender.

During the HIV Drug Resistance Workshop Ragna Boerma will present the outcomes of the MARCH-Nigeria study ‘High levels of pre-treatment HIV drug resistance in sub-Saharan Africa: original data and a systematic review’. In this study, it was found that one in six children living with HIV in Lagos, Nigeria, have HIV drug resistance before they start antiretroviral therapy. This high prevalence is in line with other studies in sub-Saharan Africa, which show increasing drug resistance rates among children over the past ten years.

Cissy Kityo will present the outcomes of the MARCH-Uganda cohort both as a presentation during the HIV drug resistance workshop and as a poster presentation at CROI: ‘Transmitted Drug Resistance and First-line ART Treatment Outcomes in Ugandan Children’. In this cohort study of 317 children, one third of all children starting first-line antiretroviral treatment experienced treatment failure in the first two years after treatment initiation. Having pre-treatment drug resistance was the most important risk factor for children to fail therapy.

Sonia Boender will present the outcomes of the PASER cohort both as an oral presentation during the HIV drug resistance workshop and as a poster presentation at CROI: ‘Protease Inhibitor Resistance at 2nd-line HIV Treatment Failure in Sub-Saharan Africa’. As increasing numbers of adults have access to first-line antiretroviral treatment in sub-Saharan Africa, the need for second-line treatment is also rising. We report on longer-term treatment outcomes and show that viral suppression on second-line treatment is high (>85%). However, drug resistance was detected in 22% of those participants failing second-line treatment. Future treatment of these individuals requires third-line drug options, which are currently unaffordable and largely unavailable sub-Saharan Africa.

MARCH – Monitoring Antiretroviral Resistance in Children
PASER – Pan-African Studies to Evaluate Resistance