{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T05:27:32Z","timestamp":1770269252915,"version":"3.49.0"},"reference-count":37,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T00:00:00Z","timestamp":1690934400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chantal BIYA International Reference Center for Research on HIV and AIDS Prevention and Management (CIRCB)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Increased HIV drug resistance (HIVDR) with antiretroviral therapy (ART) rollout may jeopardize therapeutic options, especially in this era of transition to fixed-dose tenofovir-lamivudine-dolutegravir (TLD). We studied acquired HIVDR (ADR) patterns and describe potentially active drugs after first- and second-line failure in resource-limited settings (RLS) like Cameroon. A laboratory-based study with 759 patients (\u226515 years) experiencing virological failure was carried out at the Chantal Biya International Reference Centre (CIRCB), Yaound\u00e9, Cameroon. Socio-demographic, therapeutic and immunovirological data from patient records were analysed according to HIV-1 genotypic profiles. Median (IQR) ART-duration was 63 (50\u2013308) months. Median CD4 and viremia were 153 (IQR:50\u2013308) cells\/mm3 and 138,666 (IQR:28,979\u2013533,066) copies\/mL, respectively. Overall ADR was high (93.4% first-line; 92.9%-second-line). TDF, potentially active in 35.7% of participants after first-line and 45.1% after second-line, suggested sub-optimal TLD-efficacy in second-line (64.3%) and third-line (54.9%). All PI\/r preserved high efficacy after first-line failure while only DRV\/r preserved high-level efficacy (87.9%) after second-line failure. In this resource-limited setting (RLS), ADR is high in ART-failing patients. PI\/r strategies remain potent backbones for second-line ART, while only DRV\/r remains very potent despite second-line failure. Though TLD use would be preferable, blind use for second- and third-line regimens may be sub-optimal (functional monotherapy with dolutegravir) with high risk of further failure, thus suggesting strategies for selective ART switch to TLD in failing patients in RLS.<\/jats:p>","DOI":"10.3390\/v15081683","type":"journal-article","created":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T10:57:33Z","timestamp":1690973853000},"page":"1683","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Laboratory Based Surveillance of HIV-1 Acquired Drug Resistance in Cameroon: Implications for Use of Tenofovir-Lamivudine-Dolutegravir (TLD) as Second- or Third-Line Regimens"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1501-2763","authenticated-orcid":false,"given":"Joseph","family":"Fokam","sequence":"first","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management (CIRCB), Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"},{"name":"National HIV Drug Resistance Working Group (HIVDRWG), Ministry of Public Health, Yaound\u00e9 P.O. Box 3038, Cameroon"},{"name":"Faculty of Health Sciences, University of Buea, Buea P.O. Box 063, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6749-1436","authenticated-orcid":false,"given":"Collins Ambe","family":"Chenwi","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management (CIRCB), Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"},{"name":"Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Desire","family":"Takou","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management (CIRCB), Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6228-1114","authenticated-orcid":false,"given":"Maria Mercedes","family":"Santoro","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valere","family":"Tala","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management (CIRCB), Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Teto","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management (CIRCB), Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Beloumou","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management (CIRCB), Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ezechiel Ngoufack Jagni","family":"Semengue","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management (CIRCB), Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatrice","family":"Dambaya","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management (CIRCB), Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandrine","family":"Djupsa","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management (CIRCB), Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Etienne","family":"Kembou","sequence":"additional","affiliation":[{"name":"World Health Organisation, Country Office, Yaound\u00e9 P.O. Box 155, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nounouce Pamen","family":"Bouba","sequence":"additional","affiliation":[{"name":"Department of Disease, Epidemic and Pandemic Control, Ministry of Public Health, Yaound\u00e9 P.O. Box 3038, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rogers","family":"Ajeh","sequence":"additional","affiliation":[{"name":"Central Technical Group, National AIDS Control Committee, Yaound\u00e9 P.O. Box 2005, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5353-5549","authenticated-orcid":false,"given":"Giulia","family":"Cappelli","sequence":"additional","affiliation":[{"name":"Italian National Research Council, P. le Aldo Moro, 7, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dora","family":"Mbanya","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"},{"name":"National Blood Transfusion Service, Ministry of Public Health, Yaound\u00e9 P.O. Box 3038, Cameroon"},{"name":"Haematology and Transfusion Service, Centre Hospitalier et Universitaire (CHU), Yaounde-13, Yaound\u00e9 P.O Box 30335, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vittorio","family":"Colizzi","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management (CIRCB), Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Ceccherini-Silberstein","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Faculty of Medicine and Surgery, University of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo-Federico","family":"Perno","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management (CIRCB), Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Bambino Gesu\u2019 Children\u2019s Research Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexis","family":"Ndjolo","sequence":"additional","affiliation":[{"name":"Chantal BIYA International Reference Centre for Research on HIV\/AIDS Prevention and Management (CIRCB), Messa, Yaound\u00e9 P.O. Box 3077, Cameroon"},{"name":"Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,2]]},"reference":[{"key":"ref_1","unstructured":"(2023, March 09). Global HIV & AIDS Statistics\u2014Fact Sheet. Available online: https:\/\/www.unaids.org\/en\/resources\/fact-sheet."},{"key":"ref_2","unstructured":"(2022, September 05). HIV Data and Statistics. 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