{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:56:08Z","timestamp":1762005368933,"version":"3.40.5"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>As a consequence of the improved availability of combined antiretroviral therapy (cART) in resource\u2010limited countries, an emergence of HIV drug resistance (HIVDR) has been observed. We assessed the prevalence and spectrum of HIVDR in patients with failure of second\u2010line cART at two HIV clinics in central Ethiopia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HIV drug resistance was analysed in HIV\u20101\u2010infected patients with virological failure of second\u2010line cART using the geno2pheno application.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 714 patients receiving second\u2010line cART, 44 (6.2%) fulfilled the criteria for treatment failure and 37 were eligible for study inclusion. Median age was 42 years [interquartile range (IQR): 20\u201345] and 62.2% were male. At initiation of first\u2010line cART, 23 (62.2%) were WHO stage III, mean CD4 cell count was 170.6 (range: 16\u2013496) cells\/\u00b5L and median (IQR) HIV\u20101 viral load was 30\u00a0220 (7963\u201382\u00a0598) copies\/mL. Most common second\u2010line cART regimens at the time of failure were tenofovir disoproxil fumarate (TDF)\u2010lamivudine (3TC)\u2010ritonavir\u2010boosted atazanavir (ATV\/r) (19\/37, 51.4%) and zidovudine (ZDV)\u20103TC\u2010ATV\/r (9\/37, 24.3%).<\/jats:p><jats:p>Genotypic HIV\u20101 resistance testing was successful in 35 (94.6%) participants. We found at least one resistance mutation in 80% of patients and 40% carried a protease inhibitor (PI)\u2010associated mutation. Most common mutations were M184V (57.1%), Y188C (25.7%), M46I\/L (25.7%) and V82A\/M (25.7%). High\u2010level resistance against the PI ATV (10\/35, 28.6%) and lopinavir (LPV) (5\/35, 14.3%) was reported. As expected, no resistance mutations conferring integrase inhibitor resistance were detected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found a high prevalence of resistance mutations, also against PIs (40%), as the national standard second\u2010line cART components. Resistance testing before switching to second\u2010 or third\u2010line cART is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13176","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T01:08:52Z","timestamp":1633828132000},"page":"159-168","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Characterization of HIV\u20101 drug resistance among patients with failure of second\u2010line combined antiretroviral therapy in central Ethiopia"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9505-9341","authenticated-orcid":false,"given":"Tafese Beyene","family":"Tufa","sequence":"first","affiliation":[{"name":"College of Health Sciences Arsi University  Asella Ethiopia"},{"name":"Hirsch Institute of Tropical Medicine  Asella Ethiopia"},{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases University Hospital Duesseldorf Medical Faculty Heinrich Heine University  Duesseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andre","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Hirsch Institute of Tropical Medicine  Asella Ethiopia"},{"name":"Internal Medicine III \u2013 Gastroenterology and Infectious Diseases University Hospital of Augsburg  Augsburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans Martin","family":"Orth","sequence":"additional","affiliation":[{"name":"Hirsch Institute of Tropical Medicine  Asella Ethiopia"},{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases University Hospital Duesseldorf Medical Faculty Heinrich Heine University  Duesseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadine","family":"L\u00fcbke","sequence":"additional","affiliation":[{"name":"Institute of Virology University Hospital Duesseldorf Medical Faculty Heinrich Heine University Duesseldorf  Duesseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Knops","sequence":"additional","affiliation":[{"name":"Institute of Virology University of Cologne  Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Heger","sequence":"additional","affiliation":[{"name":"Institute of Virology University of Cologne  Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Godana","family":"Jarso","sequence":"additional","affiliation":[{"name":"Adama Hospital Medical College  Adama Oromia Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zewdu","family":"Hurissa","sequence":"additional","affiliation":[{"name":"College of Health Sciences Arsi University  Asella Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yannik","family":"Eggers","sequence":"additional","affiliation":[{"name":"Hirsch Institute of Tropical Medicine  Asella Ethiopia"},{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases University Hospital Duesseldorf Medical Faculty Heinrich Heine University  Duesseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dieter","family":"H\u00e4ussinger","sequence":"additional","affiliation":[{"name":"Hirsch Institute of Tropical Medicine  Asella Ethiopia"},{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases University Hospital Duesseldorf Medical Faculty Heinrich Heine University  Duesseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Luedde","sequence":"additional","affiliation":[{"name":"Hirsch Institute of Tropical Medicine  Asella Ethiopia"},{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases University Hospital Duesseldorf Medical Faculty Heinrich Heine University  Duesseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f6rn\u2010Erik Ole","family":"Jensen","sequence":"additional","affiliation":[{"name":"Hirsch Institute of Tropical Medicine  Asella Ethiopia"},{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases University Hospital Duesseldorf Medical Faculty Heinrich Heine University  Duesseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf","family":"Kaiser","sequence":"additional","affiliation":[{"name":"Institute of Virology University of Cologne  Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torsten","family":"Feldt","sequence":"additional","affiliation":[{"name":"Hirsch Institute of Tropical Medicine  Asella Ethiopia"},{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases University Hospital Duesseldorf Medical Faculty Heinrich Heine University  Duesseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,7]]},"reference":[{"volume-title":"2017. 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