{"doi":"10.3390/v17091246","title":"Clinical, Psychosocial, and Structural Factors Associated with the Detection of HIV Drug Resistance in Children Living with HIV in Kisumu, Kenya: Secondary Analysis of Data from the Opt4Kids Study","abstract":"BACKGROUND: HIV drug resistance (DR) mutations can compromise antiretroviral therapy (ART) success among children living with HIV (CLHIV). We conducted a secondary analysis using data from a randomized control trial for ART monitoring among CLHIV in Kisumu County, Kenya from 2019 to 2023, to assess clinical, psychosocial, and structural factors associated with HIV DR. METHODS: 704 CLHIV were followed for 12+ months, with characteristics captured at enrollment and follow-up visits in the \"parent\" randomized-controlled-trial (of point-of-care plasma viral load testing and for viremias ≥ 1000 copies/mL HIV genotyping for DR vs. standard-of-care) and an observational \"extension\" substudy (of participants on a dolutegravir-containing ART with genotyping performed on viremic specimens ≥ 200 copies/mL). A multivariate modified Poisson regression model was used to analyze factors associated with sequences yielding a Stanford HIVDR database DR penalty score (DR-PS) ≥ 30 to a nucleos(t)ides and/or non-nucleoside reverse transcriptase inhibitor, protease inhibitor (PI), and/or integrase inhibitor (INSTI). RESULTS: Among 113 (16.1%) participants who underwent genotyping, 93 (82.3%) had a DR-PS ≥ 30. DR-PS ≥ 30 were associated with age 1-5 years (adjusted risk ratio (ARR) = 1.84; 95% confidence interval (CI): 1.07, 3.14), history of viremia ≥ 1000 copies/mL (ARR = 4.18; 95% CI: 2.77, 6.31), prescription of a PI- (ARR = 6.05; 95% CI: 3.43, 10.68) or INSTI-containing regimen (ARR = 1.83; 95% CI: 1.08, 3.11), poor adherence to ART (ARR = 1.91; 95% CI: 1.32, 2.76), lack of caregiver confidence in ART administration (ARR = 1.89; 95% CI: 1.11, 3.22), and mid-sized clinic populations (ARR = 0.55; 95% CI: 0.33, 0.92). CONCLUSION: Addressing social factors associated with DR-PS ≥ 30 may improve ART success among CLHIV.","journal":"Viruses","year":2025,"id":546912,"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":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9526,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1406169,"name":"Pooja Maheria","orcid":null,"position":1,"is_corresponding":false},{"id":405669,"name":"Patrick Oyaro","orcid":null,"position":2,"is_corresponding":false},{"id":404277,"name":"Katherine K. Thomas","orcid":"0000-0002-7024-468X","position":3,"is_corresponding":false},{"id":331197,"name":"Bhavna Chohan","orcid":"0000-0002-2125-6799","position":4,"is_corresponding":false},{"id":404279,"name":"Francesca Odhiambo","orcid":"0000-0002-3503-2294","position":5,"is_corresponding":false},{"id":893516,"name":"Evelyn Brown","orcid":null,"position":6,"is_corresponding":false},{"id":516384,"name":"Edwin Onyango Ochomo","orcid":"0000-0003-0180-3369","position":7,"is_corresponding":false},{"id":893517,"name":"Enericah Karauki","orcid":null,"position":8,"is_corresponding":false},{"id":893518,"name":"Nashon Yongo","orcid":null,"position":9,"is_corresponding":false},{"id":892940,"name":"Shukri A. Hassan","orcid":"0000-0001-6732-9263","position":10,"is_corresponding":false},{"id":1280639,"name":"M. Bishop","orcid":"0009-0007-1552-5562","position":11,"is_corresponding":false},{"id":377158,"name":"Ingrid A. Beck","orcid":"0000-0001-7438-3209","position":12,"is_corresponding":false},{"id":714378,"name":"Ceejay L. Boyce","orcid":"0000-0002-3716-8216","position":13,"is_corresponding":false},{"id":69658,"name":"Lisa M. Frenkel","orcid":"0000-0001-9566-8959","position":14,"is_corresponding":false},{"id":404281,"name":"Lisa Abuogi","orcid":"0000-0003-1492-5090","position":15,"is_corresponding":false},{"id":404274,"name":"Rena C. Patel","orcid":"0000-0001-9893-5856","position":16,"is_corresponding":false},{"id":912058,"name":"Andrea J. Scallon","orcid":null,"position":0,"is_corresponding":true}],"reference_count":54,"raw_metadata":null,"created_at":"2026-07-19T02:53:36.567932Z","pmid":"41012674","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":[]}