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HIV-1 Drug Resistance Mutations in Patients Failing 1st Line Therapy in a Comprehensive Care Center in Nairobi, Kenya

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World Journal of AIDS 2015年第2期5卷 83-89页

作者： Elizabeth Luvai Rebecca Waihenya James Munyao Lucy Sanguli Christina Mwachari samoel khamadi Institute of Tropical Medicine and Infectious Diseases (ITROMID) Jomo Kenyatta University of Agriculture and Technology Juja Kenya Jomo Kenyatta University of Agriculture and Technology Juja Kenya Kenya Medical Research Institute Nairobi Kenya

Background: HIV-1 drug resistance is an emerging challenge for HIV-1 infected clients who are on antiretroviral therapy (ART). In Kenya, as in many other developing countries, ART is now accesible to clients who need it. However, they must be done a CD4 test first and if the count is <300, then ART is commenced. With the initiation of ART comes the challenge of adherence to medication, a factor that is impacted greatly by the understanding of the client of the importance?of adherence and the financial ability to keep their appointments, especially if the clients come from a distant location. Objective: To identify HIV-1 drug resistance mutations inclientsfailing1st line antiretroviral therapy in Nairobi, Kenya. Methodology: A cross sectional study was carried out where whole blood samples were collected from clients attending a HIV care and treatment clinic in Nairobi. Clients who had been on ART for more than 6 months and had a viral load greater than 1000 were enrolled in the study. A total of 52 client samples were successfully sequenced in the reverse transcriptase region and analyzed. Results: After analysis of the generated sequences, it was seen that 43 (82.6%) of the clients had HIV-1 drug resistance mutations conferring resistance to one or more nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse-transcriptase inhibitors (NNRTIs). Majority of the clients (46%) were infected with HIV-1 subtype A viruses. Conclusion: The findings of the study showed that a significant proportion of the clients on ART had developed resistance mutations to one or more drugs that are used as 1st line therapy in Kenya. There is need for continuous education of the population on importance of adherence to medication. There is also need for clinicians to be trained on using viral load and HIV drug resistance testing, where available, as methods of monitoring treatment failure so that clients can be switched to alternative medication immediately the need a

关键词： HIV-1 Treatment Failure Antiretroviral Therapy Drug Resistance Subtype

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A Retrospective Analysis of Wastewater Confirms Dominant Circulation of SARS-CoV-2 Delta Variant in Nairobi, Kenya, between April 2021 and August 2021

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American Journal of Molecular Biology 2022年第3期12卷 109-121页

作者： Patson Sichamba Fred Wamunyokoli Peter Borus Rosemary Nzunza Opanda Silvanos Samwel Symekher samoel Ashimosi khamadi Janet Majanja Meshack Wadegu Esther Chitechi Benlick Mwangi Evans Komen Stephen Ombija Wallace Dimbuson Bulimo Pan African University Institute for Basic Sciences Technology and Innovation (PAUSTI) Nairobi Kenya Jomo Kenyatta University of Agriculture and Technology (JKUAT) Nairobi Kenya Kenya Medical Research Institute Centre for Virus Research Nairobi Kenya

Wastewater surveillance has been applied in various parts of the world to monitor the introduction and transmissions of SARS-CoV-2 variants in a population. The knowledge of SARS-CoV-2 variants circulating in a population is critical to COVID-19 management and timing of the application of public health countermeasures. Contrary to the routine clinical surveillance of SARS-CoV-2 where cases from asymptomatic patients are often underreported, wastewater surveillance offers an unbiased tool for monitoring the extent of SARS-CoV-2 transmissions in a community. The present study aimed to characterize SARS-CoV-2 variants that circulated in Nairobi County, Kenya, between April 2021 and August 2021 utilizing wastewater samples. Viral RNA was extracted from wastewater samples, followed by SARS-CoV-2 screening by real-time RT-qPCR before targeted sequencing of the Spike gene. Forty samples were analyzed, of which 50% (n = 20) tested positive for SARS-CoV-2 by real-time RT-qPCR. Of these, 45% (n = 9) were successfully amplified by RT-PCR and sequenced. The majority (78%, 7/9) of the viruses belonged to the Delta (B.1.617.2) lineage of SARS-CoV-2, while a minority (22%) belonged to the Alpha (B.1.1.7) and Alpha-Delta lineages. Phylogenetic analysis of the SARS-COV-2 delta lineage strains revealed scattered clustering of the Kenyan viruses among the global strains included in the analysis, suggesting different introductory routes into the country. On the whole, our results confirm previous clinical findings that SARS-CoV-2 variants belonging to the Alpha (B.1.1.7) and Delta (B.1.617.2) lineages circulated in Nairobi County, Kenya during the study period, with the latter predominating. This is the first study to describe the diversity of SARS-CoV-2 variants circulating in Kenya, through wastewater analysis.

关键词： Wastewater Surveillance SARS-CoV-2 Delta Variants Spike Gene COVID-19 Kenya

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