title: A retrospective survey of HIV drug resistance among patients 1 year after initiation of antiretroviral therapy at 4 clinics in Malawi.
abstract: In 2004, Malawi began scaling up its national antiretroviral therapy (ART) program. Because of limited treatment options, population-level surveillance of acquired human immunodeficiency virus drug resistance (HIVDR) is critical to ensuring long-term treatment success. The World Health Organization target for clinic-level HIVDR prevention at 12 months after ART initiation is ≥ 70%. In 2007, viral load and HIVDR genotyping was performed in a retrospective cohort of 596 patients at 4 ART clinics. Overall, HIVDR prevention (using viral load ≤ 400 copies/mL) was 72% (95% confidence interval [CI], 67%-77%; range by site, 60%-83%) and detected HIVDR was 3.4% (95% CI, 1.8%-5.8%; range by site, 2.5%-4.7%). Results demonstrate virological suppression and HIVDR consistent with previous reports from sub-Saharan Africa. High rates of attrition because of loss to follow-up were noted and merit attention.
authors.affiliation: Ministry of Health, Lilongwe, Malawi.
authors.forename: Nellie
authors.initials: N
authors.lastname: Wadonda-Kabondo
authors.forename: Bethany L
authors.initials: BL
authors.lastname: Hedt
authors.forename: Joep J
authors.initials: JJ
authors.lastname: van Oosterhout
authors.forename: Kundai
authors.initials: K
authors.lastname: Moyo
authors.forename: Eddie
authors.initials: E
authors.lastname: Limbambala
authors.forename: George
authors.initials: G
authors.lastname: Bello
authors.forename: Ben
authors.initials: B
authors.lastname: Chilima
authors.forename: Erik
authors.initials: E
authors.lastname: Schouten
authors.forename: Anthony
authors.initials: A
authors.lastname: Harries
authors.forename: Moses
authors.initials: M
authors.lastname: Massaquoi
authors.forename: Carol
authors.initials: C
authors.lastname: Porter
authors.forename: Ralf
authors.initials: R
authors.lastname: Weigel
authors.forename: Mina
authors.initials: M
authors.lastname: Hosseinipour
authors.forename: John
authors.initials: J
authors.lastname: Aberle-Grasse
authors.forename: Michael R
authors.initials: MR
authors.lastname: Jordan
authors.forename: Storn
authors.initials: S
authors.lastname: Kabuluzi
authors.forename: Diane E
authors.initials: DE
authors.lastname: Bennett
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000494:pharmacology* / Q000627:therapeutic use; D024882:Drug Resistance, Viral; D005260:Female; D006678:HIV / Q000187:drug effects / Q000235:genetics; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D008295:Malawi / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D016896:Treatment Outcome; D019562:Viral Load; D014944:World Health Organization
chemical_list: D044966:Anti-Retroviral Agents