{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:07:27Z","timestamp":1777853247495,"version":"3.51.4"},"reference-count":11,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>HIV drug resistance is an emerging public health concern; appropriate ART combinations and safe drug switches are prerequisites for achieving virologic suppression. In the early 2000, in Sub-Saharan Africa, accent was mostly on prevention and the scale up of Antiretroviral therapy has just initiated. We report a 46-year-old female who was initiated on ART in 2005 in the private sector, had multiple regimens changes for unclear reasons. Over 7 years (2005-2012), she deteriorated and presented with an AIDS defining condition. A genotyping resistance test (GRT) revealed multiple HIV class resistance and was switched to a third-line ART and improved on treatment. This case report shows that the absence of formal ART guidelines in early 2000, long term exposure to ART and failure to timely switch led to treatment failure and development of multiclass drug resistance mutations identified by the HIV-1 GRT and guided the third-line ART regimen with a successful outcome.<\/jats:p>","DOI":"10.1177\/23259582221110454","type":"journal-article","created":{"date-parts":[[2022,7,19]],"date-time":"2022-07-19T23:59:01Z","timestamp":1658275141000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["A Case Report of Multiclass HIV Drug-Resistance After an Inappropriate Switch of ARVs with Persistent Unsuppressed Viral Load"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7894-4536","authenticated-orcid":false,"given":"Mireille A Mpalang","family":"Kakubu","sequence":"first","affiliation":[{"name":"Ministry of Health and Social Services of Namibia, Windhoek, Namibia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mukebayi","family":"Kalonji","sequence":"additional","affiliation":[{"name":"Ministry of Health and Social Services of Namibia, Windhoek, Namibia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick D. M. C.","family":"Katoto","sequence":"additional","affiliation":[{"name":"Centre for Tropical Disease and Global Health, School of Medicine, Catholic University of Bukavu, Democratic Republic of Congo"},{"name":"Cochrane South Africa, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley 7501, Cape Town, South Africa."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,7,19]]},"reference":[{"key":"bibr1-23259582221110454","unstructured":"The Joint United Nations Programme on HIV\/AIDS. UNAIDS Strategy 2016\u20132021. 2018. Available from http:\/\/www.unaids.org\/en\/goals\/unaidsstrategy"},{"key":"bibr2-23259582221110454","doi-asserted-by":"publisher","DOI":"10.1186\/1744-8603-7-33"},{"key":"bibr3-23259582221110454","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0095956"},{"key":"bibr4-23259582221110454","unstructured":"Stanford University. 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