{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:35:16Z","timestamp":1777379716320,"version":"3.51.4"},"reference-count":63,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Research and Human Retroviruses"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:p>\n                    Barriers to sustainable virologic suppression (VS) of HIV-infected adolescents and young adults include drug resistance mutations (DRMs) and limited treatment options, which may impact the outcome of second-line antiretroviral therapy (ART). We sequenced plasma viral RNA from 74 adolescents and young adults (16\u201324 years) failing first-line ART at Newlands Clinic, Zimbabwe between October 2015 and December 2016. We evaluated first-line nucleoside reverse transcriptase inhibitor (NRTI) susceptibility scores to first- and second-line regimens. Boosted protease inhibitor (bPI)-based ART was provided and viral load (VL) monitored for \u226548 weeks. Fisher's exact test was used to evaluate factors associated with VS on second-line regimens, defined as VL &lt;1,000 copies\/mL (VS\n                    <jats:sub>1,000<\/jats:sub>\n                    ) or &lt;50 copies\/mL (VS\n                    <jats:sub>50<\/jats:sub>\n                    ). The 74 participants on first-line ART had a median [interquartile range (IQR)] age of 18 (16\u201321) years and 42 (57%) were female. The mean (\u00b1standard deviation) duration on ART was 5.5 (\u00b13.06) years and the median (IQR) log\n                    <jats:sub>10<\/jats:sub>\n                    VL was 4.26 (3.78\u20134.83) copies\/mL. After switching to a second-line PI regimen, 88% suppressed to &lt;1,000 copies\/mL and 76% to &lt;50 copies\/mL at \u226548 weeks. A new NRTI was associated with increased VS\n                    <jats:sub>50<\/jats:sub>\n                    (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u2009.031). These 74 adolescents and young adults failing first-line ART demonstrated high levels (97%) of DRMs, despite enhanced adherence counseling. Switching to new NRTIs in second-line improved VS. With the widespread adoption of generic dolutegravir, lamivudine and tenofovir combinations in Africa, genotyping to determine NRTI susceptibility, may be warranted.\n                  <\/jats:p>","DOI":"10.1089\/aid.2019.0232","type":"journal-article","created":{"date-parts":[[2020,3,6]],"date-time":"2020-03-06T01:22:22Z","timestamp":1583457742000},"page":"566-573","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Drug Resistance Among Adolescents and Young Adults with Virologic Failure of First-Line Antiretroviral Therapy and Response to Second-Line Treatment"],"prefix":"10.1177","volume":"36","author":[{"given":"Vinie","family":"Kouamou","sequence":"first","affiliation":[{"name":"Department of Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhavini","family":"Varyani","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology, Biomedical Research and Training Institute, Harare, Zimbabwe."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tinei","family":"Shamu","sequence":"additional","affiliation":[{"name":"Newlands Clinic, Newlands, Harare, Zimbabwe."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tichaona","family":"Mapangisana","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, University of Stellenbosch, Stellenbosch, South Africa."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cleophas","family":"Chimbetete","sequence":"additional","affiliation":[{"name":"Newlands Clinic, Newlands, Harare, Zimbabwe."},{"name":"Institute of Global Health, University of Geneva, Geneva, Switzerland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tinashe","family":"Mudzviti","sequence":"additional","affiliation":[{"name":"Newlands Clinic, Newlands, Harare, Zimbabwe."},{"name":"School of Pharmacy, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justen","family":"Manasa","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Katzenstein","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology, Biomedical Research and Training Institute, Harare, Zimbabwe."},{"name":"Department of Medicine, Stanford University School of Medicine, Stanford, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,7,2]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"ICAP at Columbia University. 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