HIV Drug Resistance Patterns and Characteristics Associated with Clinically Significant Drug Resistance among

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Updated: Jul 12, 2025

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
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An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

Published on: March 30, 2014

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Lisa Abuogi1, Patrick Oyaro2,3, Garoma Wakjira4

  • 1Department of Pediatrics, University of Colorado, Denver, CO 80045, USA.

Viruses
|October 28, 2023
PubMed

Insights

Drug resistance is common in children with HIV on treatment in Kenya. Prior treatment failure and shorter time on ART increase the risk of drug resistance, highlighting the need for targeted testing.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Pharmacology
  • Molecular Virology

Background:

  • Increasing HIV drug resistance (DR) poses a significant challenge for children with HIV (CHIV) on antiretroviral treatment (ART).
  • Effective management of pediatric HIV requires understanding the prevalence and drivers of drug resistance.

Purpose of the Study:

  • To describe drug resistance mutations and identify factors associated with clinically significant DR in CHIV in Kenya.
  • To evaluate the utility of point-of-care viral load testing and targeted genotypic drug resistance testing.

Main Methods:

  • A randomized controlled trial involving 704 CHIV (ages 1-14) in Kisumu County, Kenya.
  • Intervention group received point-of-care viral load testing every three months; both groups underwent targeted genotypic drug resistance testing (DRT) for virologic failure.
  • Logistic regression models were used to identify factors associated with major drug resistance.

Main Results:

  • Of 106 children with DRT results, 100% had detectable drug resistance mutations.
  • 88% had major mutations, and 54% exhibited dual-class resistance.
  • History of virologic failure (VF) in the prior 2 years (aOR 11.1) and <2 years on ART at enrollment (aOR 2.2) were associated with increased odds of major DR.

Conclusions:

  • Drug resistance is highly prevalent among CHIV with VF in Kenya.
  • Identifying children at higher risk for DR through factors like prior VF and time on ART can guide prioritization for DRT.
  • Point-of-care testing strategies may improve management of pediatric HIV.

Keywords:
childrendrug resistancehuman immunodeficiency virus (HIV)virologic failure

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