Dolutegravir Resistance in Malawi's National HIV Treatment Program

Joep J van Oosterhout; Chifundo Chipungu; Lyse Nkhoma; Hope Kanise; Mina C Hosseinipour; Jean Babtiste Sagno; Katherine Simon; Carrie Cox; Risa Hoffman; Kim Steegen; Bilaal W Matola; Sam Phiri; Andreas Jahn; Rose Nyirenda; Tom Heller

doi:10.1093/ofid/ofac148

Dolutegravir Resistance in Malawi's National HIV Treatment Program

Open Forum Infect Dis. 2022 Apr 5;9(5):ofac148. doi: 10.1093/ofid/ofac148. eCollection 2022 May.

Authors

Joep J van Oosterhout^{1

2}, Chifundo Chipungu¹, Lyse Nkhoma³, Hope Kanise¹, Mina C Hosseinipour⁴, Jean Babtiste Sagno⁵, Katherine Simon^{6

7}, Carrie Cox^{6

7}, Risa Hoffman², Kim Steegen^{8

9}, Bilaal W Matola¹⁰, Sam Phiri^{1

10}, Andreas Jahn¹¹, Rose Nyirenda¹¹, Tom Heller³

Affiliations

¹ Partners in Hope, Lilongwe, Malawi.
² Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
³ The Lighthouse Trust, Lilongwe, Malawi.
⁴ University of North Carolina Project Malawi, Lilongwe, Malawi.
⁵ DREAM, Communion of St. Egidio, Blantyre, Malawi.
⁶ Baylor College of Medicine Children's Foundation-Malawi, Lilongwe, Malawi.
⁷ Baylor International Pediatric AIDS Initiative, Houston, Texas, USA.
⁸ Department of Haematology & Molecular Medicine, National Health Laboratory Service, Johannesburg, South Africa.
⁹ Department of Haematology & Molecular Medicine, University of the Witwatersrand, Johannesburg, South Africa.
¹⁰ Department of Public Health and Family Medicine, Kamuzu University of Health Sciences, Lilongwe, Malawi.
¹¹ Department of HIV-AIDS, Ministry of Health, Lilongwe, Malawi.

Abstract

Dolutegravir HIV drug resistance (HIVDR) data from Africa remain sparse. We reviewed HIVDR results of Malawians on dolutegravir-based antiretroviral therapy (November 2020-September 2021). Of 6462 eligible clients, 33 samples were submitted to South Africa, 27 were sequenced successfully, and 8 (30%) had dolutegravir HIVDR. Malawi urgently requires adequate HIVDR testing capacity.

Keywords: Africa; HIV; Malawi; antiretroviral therapy; dolutegravir; resistance.