Clinical, molecular, and drug resistance epidemiology of HIV in Jordan, 2019-2021: A national study.

Autor:	Bakri FG; Division of Infectious Diseases, Department of Internal Medicine, Jordan University Hospital, Amman, Jordan; Infectious Diseases and Vaccine Center, University of Jordan, Amman, Jordan., Mukattash HH; Primary Health Care Directorate, Ministry of Health, Amman, Jordan., Esmeiran H; HJF Medical Research International (HJFMRI), Amman, Jordan., Schluck G; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD., Storme CK; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD., Broach E; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD., Mebrahtu T; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD., Alhawarat M; Communicable Diseases Directorate, Ministry of Health, Amman, Jordan., Valencia-Ruiz A; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD; Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD., M'Hamdi O; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD; Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD., Malia JA; Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD., Hassen Z; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD., Shafei MMS; Central Public Health Laboratory, Ministry of Health, Amman, Jordan., Alkhatib AY; Voluntary Counselling and Testing Center, Ministry of Health, Amman, Jordan., Gazo M; Central Public Health Laboratory, Ministry of Health, Amman, Jordan., Jaradat SA; Princess Haya Biotechnology Center, Jordan University of Science and Technology, Irbid, Jordan., Gomez Y; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD; Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD., McGeehon S; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD; Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD., McCauley MD; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD; Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD., Moreland SC; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD; Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD., Darden JM; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD; Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD., Amare M; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD; Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD., Crowell TA; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD., Vasan S; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD., Michael NL; Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD., Ake JA; United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD., Modjarrad K; Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD., Scott PT; Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD., Peel SA; Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD., Hakre S; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD; Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD. Electronic address: shakre@eidresearch.org.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2024 Aug; Vol. 145, pp. 107079. Date of Electronic Publication: 2024 Apr 30.
DOI:	10.1016/j.ijid.2024.107079
Abstrakt:	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. Competing Interests: Declarations of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu