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- Title
Archived rilpivirine-associated resistance mutations among ART-naive and virologically suppressed people living with HIV-1 subtype C in Botswana: implications for cabotegravir/rilpivirine use.
- Authors
Maruapula, Dorcas; Moraka, Natasha O; Bareng, Ontlametse T; Mokgethi, Patrick T; Choga, Wonderful T; Seatla, Kaelo K; Kelentse, Nametso; Koofhethille, Catherine K; Zuze, Boitumelo J L; Gaolathe, Tendani; Pretorius-Holme, Molly; Makhema, Joseph; Novitsky, Vlad; Shapiro, Roger; Moyo, Sikhulile; Lockman, Shahin; Gaseitsiwe, Simani
- Abstract
Objectives Pre-existing rilpivirine resistance-associated mutations (RVP-RAMs) have been found to predict HIV-1 virological failure in those switching to long-acting injectable cabotegravir/rilpivirine. We here evaluated the prevalence of archived RPV-RAMs in a cohort of people living with HIV (PWH). Methods We analysed near full-length HIV-1 pol sequences from proviral DNA for the presence of RPV-RAMs, which were defined according to the 2022 IAS–USA drug resistance mutation list and Stanford HIV drug resistance database. Results RPV-RAMs were identified in 757/5805 sequences, giving a prevalence of 13.0% (95% CI 12%–13.9%). Amongst the ART-naive group, 137/1281 (10.7%, 95% CI 9.1%–12.5%) had at least one RPV-RAM. Of the 4524 PWH with viral suppression on ART (VL <400 copies/mL), 620 (13.7%, 95% CI 12.7%–14.7%) had at least one RPV-RAM. E138A was the most prevalent RPV-RAM in the ART-naive group (7.9%) and the ART-suppressed group (9.3%). The rest of the mutations observed (L100I, K101E, E138G, E138K, E138Q, Y181C, H221Y, M230L, A98G, V179D, G190A, G190E and M230I) were below a prevalence of 1%. Conclusions RPV-RAMs were present in 10.7% of ART-naive and 13.7% of ART-suppressed PWH in Botswana. The most common RPV-RAM in both groups was E138A. Since individuals with the E138A mutation may be more likely to fail cabotegravir/rilpivirine, monitoring RPV-RAMs will be crucial for effective cabotegravir/rilpivirine implementation in this setting.
- Subjects
BOTSWANA; HIV; ANTI-HIV agents; HIV-positive persons; DRUG resistance; DATABASES
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2023, Vol 78, Issue 10, p2489
- ISSN
0305-7453
- Publication type
Article
- DOI
10.1093/jac/dkad258