title: Prevalence of HIV drug resistance before and 1 year after treatment initiation in 4 sites in the Malawi antiretroviral treatment program.
abstract: Since 2004, the Malawi antiretroviral treatment (ART) program has provided a public health-focused system based on World Health Organization clinical staging, standardized first-line ART regimens, limited laboratory monitoring, and no patient-level monitoring of human immunodeficiency virus drug resistance (HIVDR). The Malawi Ministry of Health conducts periodic evaluations of HIVDR development in prospective cohorts at sentinel clinics. We evaluated viral load suppression, HIVDR, and factors associated with HIVDR in 4 ART sites at 12-15 months after ART initiation. More than 70% of patients initiating ART had viral suppression at 12 months. HIVDR prevalence (6.1%) after 12 months of ART was low and largely associated with baseline HIVDR. Better follow-up, removal of barriers to on-time drug pickups, and adherence education for patients 16-24 years of age may further prevent HIVDR.
authors.affiliation: Department of Preventive Health, Ministry of Health, Lilongwe, Malawi. nelliewadonda@hotmail.com
authors.forename: Nellie
authors.initials: N
authors.lastname: Wadonda-Kabondo
authors.forename: Diane
authors.initials: D
authors.lastname: Bennett
authors.forename: Joep J
authors.initials: JJ
authors.lastname: van Oosterhout
authors.forename: Kundai
authors.initials: K
authors.lastname: Moyo
authors.forename: Mina
authors.initials: M
authors.lastname: Hosseinipour
authors.forename: Josh
authors.initials: J
authors.lastname: Devos
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Zhou
authors.forename: John
authors.initials: J
authors.lastname: Aberle-Grasse
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Warne
authors.forename: Clement
authors.initials: C
authors.lastname: Mtika
authors.forename: Ben
authors.initials: B
authors.lastname: Chilima
authors.forename: Richard
authors.initials: R
authors.lastname: Banda
authors.forename: Olesi
authors.initials: O
authors.lastname: Pasulani
authors.forename: Carol
authors.initials: C
authors.lastname: Porter
authors.forename: Sam
authors.initials: S
authors.lastname: Phiri
authors.forename: Andreas
authors.initials: A
authors.lastname: Jahn
authors.forename: Debbie
authors.initials: D
authors.lastname: Kamwendo
authors.forename: Michael R
authors.initials: MR
authors.lastname: Jordan
authors.forename: Storn
authors.initials: S
authors.lastname: Kabuluzi
authors.forename: Frank
authors.initials: F
authors.lastname: Chimbwandira
authors.forename: Mathew
authors.initials: M
authors.lastname: Kagoli
authors.forename: Blackson
authors.initials: B
authors.lastname: Matatiyo
authors.forename: Austin
authors.initials: A
authors.lastname: Demby
authors.forename: Chunfu
authors.initials: C
authors.lastname: Yang
mesh_terms: D000293:Adolescent; 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; D055118:Medication Adherence; D009313:National Health Programs; D015995:Prevalence; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D044966:Anti-Retroviral Agents