{"doi":"10.1093/jac/dkae472","title":"High prevalence of reverse transcriptase inhibitors associated resistance mutations among people living with HIV on dolutegravir-based antiretroviral therapy in Francistown, Botswana","abstract":"OBJECTIVES: We assessed HIV-1 drug resistance profiles among people living with HIV (PLWH) with detectable viral load (VL) and on dolutegravir-based antiretroviral therapy (ART) in Botswana. METHODS: The study utilised available 100 residual HIV-1 VL samples from unique PLWH in Francistown who had viraemia at-least 6 months after initiating ART in Botswana's national ART program from November 2023 to January 2024. Viraemia was categorized as low-level viraemia (LLV) (VL: 200-999 copies/mL) or virologic failure (VF) (VL ≥1000 copies/mL). HIV-1 protease, reverse transcriptase and integrase genes were sequenced using an in-house next-generation sequencing Oxford nanopore technology. HIV-1 drug resistance mutations (DRMs) were identified using the HIVdb Program in the Stanford HIV drug resistance database and compared between VL groups. RESULTS: Among 100 participants, 83.0% were on dolutegravir-based, 10.0% were on non-dolutegravir-based ART and 7.0% had unknown/undocumented ART regimens. Thirty (30%) participants had LLV and 70 (70%) had VF. Among 58 successfully sequenced, 32.8% [95% Confidence Interval (CI): 21.8-46.0] had DRMs to any drug class, 33.3% (4/12) in the LLV group and 32.6% (15/46) in the VF group. Among individuals on dolutegravir-based ART, the overall HIV DRMs were 34.8% (95% CI: 22.7-49.2). By VL groups, 40.0% (95% CI: 16.8-68.7) and 33.3% (95% CI: 20.2-50.0) had DRMs at LLV and VF, respectively. CONCLUSIONS: A high but similar prevalence of any DRMs was observed among individuals with LLV and those with VF on dolutegravir-based therapy. Monitoring DRMs in individuals with detectable VL is crucial for preserving dolutegravir-based ART.","journal":"Journal of Antimicrobial Chemotherapy","year":2024,"id":460673,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8793,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1289296,"name":"Goitseone Martha Lemogang","orcid":null,"position":1,"is_corresponding":false},{"id":425978,"name":"Wonderful T. Choga","orcid":"0000-0001-7606-0569","position":2,"is_corresponding":false},{"id":1289297,"name":"Gaonyadiwe Muzanywa","orcid":null,"position":3,"is_corresponding":false},{"id":1289298,"name":"Thembinkosi M Shadreck","orcid":null,"position":4,"is_corresponding":false},{"id":1289299,"name":"Charity Ralegoreng","orcid":null,"position":5,"is_corresponding":false},{"id":438190,"name":"Dorcas Maruapula","orcid":"0000-0003-2587-8904","position":6,"is_corresponding":false},{"id":514549,"name":"Natasha O. Moraka","orcid":"0000-0001-5333-4010","position":7,"is_corresponding":false},{"id":943284,"name":"Catherine K. Koofhethile","orcid":"0000-0001-5475-413X","position":8,"is_corresponding":false},{"id":941551,"name":"Patrick Mokgethi","orcid":null,"position":9,"is_corresponding":false},{"id":1119773,"name":"Kedumetse Seru","orcid":"0009-0005-9456-6367","position":10,"is_corresponding":false},{"id":838678,"name":"Boitumelo Zuze","orcid":"0009-0005-5283-7763","position":11,"is_corresponding":false},{"id":1289300,"name":"Patience Montshosi","orcid":null,"position":12,"is_corresponding":false},{"id":940997,"name":"Irene Gobe","orcid":"0000-0003-3679-6509","position":13,"is_corresponding":false},{"id":838671,"name":"Modisa S. Motswaledi","orcid":"0000-0001-8163-7166","position":14,"is_corresponding":false},{"id":425980,"name":"Rosemary Musonda","orcid":"0009-0009-9937-6908","position":15,"is_corresponding":false},{"id":840310,"name":"Mpaphi B. Mbulawa","orcid":null,"position":16,"is_corresponding":false},{"id":393322,"name":"Joseph Makhema","orcid":"0000-0003-0017-2438","position":17,"is_corresponding":false},{"id":431953,"name":"Roger Shapiro","orcid":"0000-0002-4832-6275","position":18,"is_corresponding":false},{"id":257497,"name":"Shahin Lockman","orcid":"0000-0002-5384-9716","position":19,"is_corresponding":false},{"id":1251439,"name":"Tony Chebani","orcid":null,"position":20,"is_corresponding":false},{"id":1289301,"name":"Judith Nawa","orcid":null,"position":21,"is_corresponding":false},{"id":1289302,"name":"Lindani Bochena","orcid":null,"position":22,"is_corresponding":false},{"id":425983,"name":"Sikhulile Moyo","orcid":"0000-0003-3821-4592","position":23,"is_corresponding":false},{"id":425985,"name":"Simani Gaseitsiwe","orcid":"0000-0002-7089-3735","position":24,"is_corresponding":false},{"id":940996,"name":"Ontlametse T. Bareng","orcid":"0009-0005-8147-2193","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-19T02:04:07.925246Z","pmid":"39764689","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}