title: Emergence of untreatable, multidrug-resistant HIV-1 in patients failing second-line therapy in Kenya.
abstract: : We performed a countrywide assessment of HIV drug resistance among 123 patients with virological failure on second-line antiretroviral therapy (ART) in Kenya. The percentage of patients harbouring intermediate-to-high-level resistance was 27% for lopinavir-ritonavir, 24% for atazanavir-ritonavir and 7% for darunavir-ritonavir, and 25% had complete loss of activity to all available first and second-line drugs. Overall, one in four patients failing second-line ART have completely exhausted available antiretrovirals in Kenya, highlighting the need for increased access to third-line drugs.
authors.affiliation: aDepartment of Global Health, Academic Medical Center of the University of Amsterdam, and Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands bKenya Medical Research Institute, Kisumu, Kenya cDepartment of Internal Medicine, Division of Infectious Diseases, Academic Medical Center of the University of Amsterdam, Amsterdam, the Netherlands dNational AIDS & STI Control Programme, Nairobi, Kenya eUS Centers for Disease Control and Prevention, Kisumu, Kenya.
authors.forename: Seth C
authors.initials: SC
authors.lastname: Inzaule
authors.forename: Raph L
authors.initials: RL
authors.lastname: Hamers
authors.forename: Irene
authors.initials: I
authors.lastname: Mukui
authors.forename: Kennedy
authors.initials: K
authors.lastname: Were
authors.forename: Prestone
authors.initials: P
authors.lastname: Owiti
authors.forename: Daniel
authors.initials: D
authors.lastname: Kwaro
authors.forename: Tobias F
authors.initials: TF
authors.lastname: Rinke de Wit
authors.forename: Clement
authors.initials: C
authors.lastname: Zeh
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D003430:Cross-Sectional Studies; D024921:Drug Resistance, Multiple, Viral; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents