Predictive Factors of HIV-1 Drug Resistance and Its Distribution among Female Sex Workers in the Democratic Republic of the Congo (DRC)
Abstract
:1. Introduction
1.1. Background of the Study
1.2. Objectives of the Study
1.3. Specific Aims and Hypothesis
- To determine the sociodemographic characteristics of the HIV-positive FSWs in the DRC;
- To determine the prevalence of HIV drug resistance mutations (HIVDRMs) based on the HIV-1 VL in FSWs in the DRC;
- To determine the HIVDRM distribution based on the study groups in the DRC;
- To identify the factors associated with HIVDRMs in FSWs in the DRC.
2. Methods
2.1. Data Source
2.2. IBBS Design, Setting and Population
2.3. Sociodemographic Characteristics and HIV Risk Behavior Data
2.4. Laboratory Procedures
2.4.1. Measuring HIV-1 Viral Load
2.4.2. HIV-1 Subtype Identification and Detection of Drug Resistance Mutations
2.4.3. Syphilis Testing
2.5. Study Variables
2.6. Statistical Analysis
2.7. Ethical Approval
3. Results
3.1. Sociodemographic Characteristics and HIV Risk Behaviors of FSWs
3.2. HIV-1 Drug Resistance Distribution
3.3. HIV-1 Drug Resistance Mutations According to HIV-1 VL
3.4. Factors Associated with ART Resistance in FSWs
4. Discussion
4.1. Sociodemographic Characteristics and HIV Risk Behaviors of FSWs
4.2. HIV-1 Drug Resistance Mutations According to HIV-1 VL
4.3. Factors Associated with ART Resistance in FSWs in DRC
4.4. Limitations
5. Conclusions and Implications for Translation
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | n | % |
---|---|---|
Age category (years) (n = 324) | ||
˂20 | 21 | 6.5 |
20–24 | 47 | 14.5 |
25–49 | 256 | 79.0 |
Education level (n = 324) | ||
No formal education | 51 | 15.7 |
Primary | 119 | 36.7 |
Secondary and above | 154 | 47.5 |
Duration in sex trade (years) (n = 323) * | ||
≥5 | 131 | 40.6 |
˂5 | 192 | 59.4 |
Alcohol use (n = 322) * | ||
Yes | 249 | 77.3 |
No | 73 | 22.7 |
Marital status (n = 324) | ||
Married | 216 | 66.7 |
Unmarried | 108 | 33.3 |
Genital ulcerations in 12 months prior to survey (n = 322) * | ||
Yes | 76 | 23.6 |
No | 246 | 76.4 |
Abnormal genital secretions in 12 months prior to survey(n = 323) * | ||
Yes | 97 | 30.0 |
No | 226 | 70.0 |
HIV-1–syphilis coinfection status (n = 324) | ||
Yes | 75 | 30.0 |
No | 249 | 76.9 |
HIV-1 viral load (log10 HIV RNA/mL) (n = 265) | ||
≥3.0 | 123 | 46.4 |
˂3.0 | 142 | 53.6 |
HIV drug resistance (n = 93) ** | ||
Yes | 20 | 21.5 |
No | 73 | 78.5 |
HIV-1 VL | DR Prevalence | ID | HIV Clade | HIV Drug Mutations (Scores) | p | ||
---|---|---|---|---|---|---|---|
POL | PI | NRTI | NNRTI | ||||
˂3.0 log10 RNA copies/mL | 4/35 (11.4%) | 4-B7 | D | E138G (45) | 0.028 | ||
2-A7 | C | K65R (150) | |||||
2-D4 | A1/C | L33F (15) | |||||
1-E8 | A1/G/A1/F1/C/G/K | M184V (115) | G190A (130) | ||||
≥3.0 log10 RNA copies/mL | 14/43 (32.6%) | 3-A3 | D | K219R (20) | |||
2-A6 | A | K103N (120) | |||||
4-G5 | G | V179E (40) | |||||
3-F6 | C | M184V (115) | A98G/V179D/Y181C (295) | ||||
2-C3 | A | L33F (15) | |||||
2-E2 | CRF05_DF | K103N (120) | |||||
2-E8 | A | M184V (115) | A98G/K103N (190) | ||||
2-C6 | C | E138A (25) | |||||
2-H1 | C | M184I (115) | |||||
3-D4 | A1/K/A1/C | V179T (0) | |||||
3-I7 | A | M184V (115) | K103N (120) | ||||
3-E6 | B/C | E138A (25) | |||||
2-D8 | D/G/H/A1 | K103N (120) | |||||
1-B7 | A | I54V (30) |
Characteristics | Resistance to ART | Crude OR(95% CI) | p | Adjusted OR(95% CI) | p | |
---|---|---|---|---|---|---|
Yes n (%) | No n (%) | |||||
Age category (years) | ||||||
| 3 (33.3) | 6 (66.7) | 1 | 1 | ||
| 4 (26.7) | 11 (73.3) | 0.73 (0.12–4.39) | 0.728 | 0.30 (0.01–6.03) | 0.428 |
| 13 (18.8) | 56 (81.2) | 0.46 (0.10–2.11) | 0.320 | 0.74 (0.06–8.90) | 0.812 |
Education level | ||||||
| 4 (23.5) | 13 (76.5) | 1 | 1 | ||
| 6 (17.6) | 28 (82.4) | 0.70 (0.17–2.90) | 0.619 | 0.83 (0.13–5.30) | 0.840 |
| 10 (23.8) | 32 (76.2) | 1.02 (0.27–3.83) | 0.982 | 2.48 (0.38–16.11) | 0.341 |
Duration in sex trade (years) | ||||||
| 12 (20.3) | 47 (79.7) | 1 | 1 | ||
| 8 (23.5) | 26(76.5) | 1.21 (0.44–3.33) | 0.719 | 1.65 (0.28–9.64) | 0.576 |
Alcohol use | ||||||
| 59 (80.8) | 14 (19.2) | 1 | 1 | ||
| 15 (75.0) | 5 (25.0) | 1.51 (0.47–4.91) | 0.491 | 2.18 (0.37–12.75) | 0.386 |
Marital Status | ||||||
| 47 (64.4) | 26 (35.6) | 1 | 1 | ||
| 10 (50.0) | 10 (50.0) | 1.81 (0.67–4.91) | 0.245 | 3.10 (0.52–18.48) | 0.215 |
Genital ulcerations in 12 months prior to survey | ||||||
| 11 (15.9) | 58 (84.1) | 1 | 1 | ||
| 9 (37.5) | 15 (62.5) | 3.16 (1.11–9.02) | 0.031 | 1.13 (0.16–7.84) | 0.901 |
Abnormal genital secretions in 12 months prior to survey | ||||||
| 8 (12.5) | 56 (87.5) | 1 | 1 | ||
| 12 (41.4) | 17 (58.6) | 4.94 (1.74–14.07) | 0.003 | 8.51 (1.62–44.74) | 0.011 |
HIV-1 Viral Load | ||||||
| 4 (11.4) | 31 (88.6) | 1 | 1 | ||
| 14 (32.6) | 29 (67.4) | 3.74 (1.10–12.69) | 0.034 | 5.39 (1.09–26.74) | 0.039 |
HIV-1–syphilis coinfection status | ||||||
| 8(12.7) | 55(87.3) | 1 | 1 | ||
| 12(40.0) | 18(60.0) | 4.58 (1.62–12.98) | 0.004 | 9.71 (1.84–51.27) | 0.007 |
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Musema, G.M.A.; Akilimali, P.Z.; za Balega, T.K.N.; Tshala-Katumbay, D.; Lusamba, P.-S.D. Predictive Factors of HIV-1 Drug Resistance and Its Distribution among Female Sex Workers in the Democratic Republic of the Congo (DRC). Int. J. Environ. Res. Public Health 2022, 19, 2021. https://doi.org/10.3390/ijerph19042021
Musema GMA, Akilimali PZ, za Balega TKN, Tshala-Katumbay D, Lusamba P-SD. Predictive Factors of HIV-1 Drug Resistance and Its Distribution among Female Sex Workers in the Democratic Republic of the Congo (DRC). International Journal of Environmental Research and Public Health. 2022; 19(4):2021. https://doi.org/10.3390/ijerph19042021
Chicago/Turabian StyleMusema, Godefroid Mulakilwa Ali, Pierre Zalagile Akilimali, Takaisi Kikuni Ntonbo za Balega, Désiré Tshala-Katumbay, and Paul-Samson Dikasa Lusamba. 2022. "Predictive Factors of HIV-1 Drug Resistance and Its Distribution among Female Sex Workers in the Democratic Republic of the Congo (DRC)" International Journal of Environmental Research and Public Health 19, no. 4: 2021. https://doi.org/10.3390/ijerph19042021
APA StyleMusema, G. M. A., Akilimali, P. Z., za Balega, T. K. N., Tshala-Katumbay, D., & Lusamba, P.-S. D. (2022). Predictive Factors of HIV-1 Drug Resistance and Its Distribution among Female Sex Workers in the Democratic Republic of the Congo (DRC). International Journal of Environmental Research and Public Health, 19(4), 2021. https://doi.org/10.3390/ijerph19042021