A cross‐sectional study evaluating the frequency of HIV drug resistance mutations among individuals diagnosed with HIV‐1 in tenofovir disoproxil fumarate‐based pre‐exposure prophylaxis rollout programmes in Kenya, Zimbabwe, Eswatini and South Africa

作者：Urvi M. Parikh, Lauren D. Kudrick, Lisa Levy, Everline Bosek, Bhavna Chohan, Irene Mukui, Sarah Masyuko, Nonhlanhla Ndlovu, Imelda Mahaka, Owen Mugurungi, Gertrude Ncube, Anita Hettema, Sindy Matse, Saiqa Mullick, Carole L. Wallis, Amy Heaps, Kerri J. Penrose, Kevin D. McCormick, Lubbe Wiesner, Peter L. Anderson, Jill Peterson, Connie Celum, Barbra A. Richardson, Delivette Castor, Shannon A. Allen, Kristine Torjesen, John W. Mellors, Global Evaluation of Microbicide Sensitivity (GEMS) Project · 发表于：Journal of the International AIDS Society · 年份：2025 · DOI：10.1002/jia2.70011 · 被引用次数：3 · 研究领域：HIV/AIDS drug development and treatment、HIV/AIDS Research and Interventions、HIV Research and Treatment

INTRODUCTION: The ongoing rollout of oral tenofovir-based pre-exposure prophylaxis (PrEP) has the potential to reduce HIV-1 incidence, but HIV drug resistance (HIVDR) in individuals who acquire HIV-1 on PrEP could threaten the treatment effectiveness of overlapping antiretrovirals (tenofovir/emtricitabine), contribute to development of resistance, and undermine HIV control efforts. Accordingly, the Global Evaluation of Microbicide Sensitivity (GEMS) project was established to monitor HIVDR in PrEP rollout programmes in Southern and Eastern Africa. METHODS: GEMS monitored resistance in >100,000 estimated persons who accessed PrEP through national programmes or implementation projects in Southern/Eastern Africa. Participants self-reported demographics and PrEP adherence. HIV-1 RNA and tenofovir-diphosphate levels were measured in blood samples collected at the time of study enrolment from consenting participants diagnosed with HIV who had received PrEP. HIVDR mutations were detected by population genotyping. RESULTS: Of 283 reported seroconversions on PrEP from December 2017 through September 2023, 255 (90%) individuals enrolled in GEMS, of which 81 (32%) were from Kenya, 77 (30%) from South Africa, 69 (27%) from Zimbabwe and 28 (11%) from Eswatini. Half (130; 51%) were 15-24 years of age at seroconversion, and three-quarters (193; 76%) were female. Thirty-four seroconversions occurred within 30 days of PrEP initiation. Tenofovir-diphosphate levels were consistent with moderate...