TY - JOUR
T1 - HIV-1 Antiretroviral Drug Resistance in Mozambique
T2 - A Systematic Review and Meta-Analysis
AU - Gonçalves, Paloma
AU - Mascarenhas, Paulo
AU - Marcelino, Rute
AU - Mabunda, Nédio
AU - Kroidl, Arne
AU - Buck, W. Chris
AU - Jani, Ilesh
AU - Palladino, Claudia
AU - Taveira, Nuno
N1 - Publisher Copyright:
© 2024 by the authors.
PY - 2024/12
Y1 - 2024/12
N2 - This systematic review assessed the prevalence of transmitted and acquired HIV drug resistance (HIVDR) and the associated risk factors in Mozambique. A search of the PubMed, Cochrane, B-On, and Scopus databases up to December 2023 was conducted and included 11 studies with 1118 HIV-1 pol sequences. Drug resistance mutations (DRMs) to NNRTIs were found in 13% of the drug-naive individuals and 31% of those on ART, while NRTI resistance occurred in 5% and 10%, respectively. Dual-class resistance (NNRTI + NRTI) was detected in 2% of the drug-naive and 8% of ART-experienced individuals. DRMs to protease inhibitors (PIs) were found in 2% of the drug-naive and 5% of ART-experienced individuals. The rate of DRMs was significantly higher in Beira than in Maputo, as well as in pediatric patients than in adults and pregnant women. Subtype C predominated (94%) and was associated with lower viral loads and DRM rates as compared to the other subtypes. The high prevalence of DRMs, particularly to NNRTIs and NRTIs, highlights the need for ongoing surveillance and targeted interventions. These findings are critical for optimizing ART regimens and informing public health strategies in Mozambique, with particular attention to regions such as Beira and vulnerable populations such as pediatric patients.
AB - This systematic review assessed the prevalence of transmitted and acquired HIV drug resistance (HIVDR) and the associated risk factors in Mozambique. A search of the PubMed, Cochrane, B-On, and Scopus databases up to December 2023 was conducted and included 11 studies with 1118 HIV-1 pol sequences. Drug resistance mutations (DRMs) to NNRTIs were found in 13% of the drug-naive individuals and 31% of those on ART, while NRTI resistance occurred in 5% and 10%, respectively. Dual-class resistance (NNRTI + NRTI) was detected in 2% of the drug-naive and 8% of ART-experienced individuals. DRMs to protease inhibitors (PIs) were found in 2% of the drug-naive and 5% of ART-experienced individuals. The rate of DRMs was significantly higher in Beira than in Maputo, as well as in pediatric patients than in adults and pregnant women. Subtype C predominated (94%) and was associated with lower viral loads and DRM rates as compared to the other subtypes. The high prevalence of DRMs, particularly to NNRTIs and NRTIs, highlights the need for ongoing surveillance and targeted interventions. These findings are critical for optimizing ART regimens and informing public health strategies in Mozambique, with particular attention to regions such as Beira and vulnerable populations such as pediatric patients.
KW - antiretroviral therapy (ART)
KW - drug resistance mutations (DRMs)
KW - HIV drug resistance (HIVDR)
KW - Mozambique
KW - systematic review and meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=85213206535&partnerID=8YFLogxK
U2 - 10.3390/v16121808
DO - 10.3390/v16121808
M3 - Review article
AN - SCOPUS:85213206535
SN - 1999-4915
VL - 16
JO - Viruses
JF - Viruses
IS - 12
M1 - 1808
ER -