학술논문
Clinical, molecular, and drug resistance epidemiology of HIV in Jordan, 2019-2021: A national study
Document Type
article
Author
Faris G. Bakri; Heyam H. Mukattash; Hiam Esmeiran; Glenna Schluck; Casey K. Storme; Erica Broach; Tsedal Mebrahtu; Mohammad Alhawarat; Anais Valencia-Ruiz; Oussama M'Hamdi; Jennifer A. Malia; Zebiba Hassen; Mah'd M.S. Shafei; Ala Y. Alkhatib; Mahmoud Gazo; Saied A. Jaradat; Yessenia Gomez; Samantha McGeehon; Melanie D. McCauley; Sarah C. Moreland; Janice M. Darden; Mihret Amare; Trevor A. Crowell; Sandhya Vasan; Nelson L. Michael; Julie A. Ake; Kayvon Modjarrad; Paul T. Scott; Sheila A. Peel; Shilpa Hakre
Source
International Journal of Infectious Diseases, Vol 145, Iss , Pp 107079- (2024)
Subject
Language
English
ISSN
1201-9712
Abstract
Background: Limited epidemiologic studies have been conducted in Jordan describing the HIV epidemic. This study aimed to address this gap to inform HIV prevention and control. Methods: A nationally-representative cross-sectional study was conducted among adults living with HIV in Jordan. Laboratory testing included HIV viral load and next-generation-sequencing-based clinical genotype. Log-binomial regression estimated risk ratios (RRs) and 95% confidence intervals (CIs). Results: Among 231 (70%) participants, most were male (184/80%), and from Jordan (217/94%). Among 188 treatment-experienced-participants (>6 months), 165 (88%) were virally suppressed. High-level resistance was most frequent against nucleoside reverse transcriptase inhibitor (13/81%), and integrase-strand transfer inhibitor (INSTI) (10/62%) drugs among viremic (≥1000 HIV copies/mL) treatment-experienced participants with drug-resistant mutations (DRMs, n = 16). Common HIV subtypes (n = 43) were B (6/14%), A1 (5/12%), and CRF01_AE (5/12%); additionally, novel recombinant forms were detected. In multivariate analysis, independently higher risk for late diagnosis (n = 49) was observed with diagnosis through blood donation (vs check-up: RR 2.20, 95%CI 1.16-4.17) and earlier time-period of diagnosis (1986-2014 vs 2015-2021: RR 2.87, 95%CI 1.46-5.62). Conclusions: Late diagnosis and INSTI resistance endanger national HIV prevention and treatment in Jordan—high-level resistance to INSTI suggests therapeutic drug monitoring is needed for treatment efficacy and conservation of treatment options.