High prevalence of reverse transcriptase inhibitors associated resistance mutations among people living with HIV on dolutegravir-based antiretroviral therapy in Francistown, Botswana

Since 2016, clinicians in Botswana have been prescribing dolutegravir as antiretroviral therapy (ART) for HIV. Before this project, the authors state, no study had characterised HIV-1 drug resistance mutations in people living with HIV on dolutegravir-based ART in the Botswana National ART program. Using Oxford Nanopore sequencing, Choga et al. achieved fast, accurate sequencing of HIV-1 genes, and uncovered key antiretroviral resistance mutations. Its cost effectiveness and rapid turnaround time made Oxford Nanopore sequencing a game changer for preventing treatment failure in resource-limited settings.

Key points:

• Choga et al. obtained plasma samples from 100 individuals with HIV.

• HIV drug resistance mutations were detected in 32.8% of the sequenced samples, with prevalence not correlated to viral load.

• Resistance to other antiretrovirals was prevalent, with a lower incidence of dolutegravir-associated resistance mutations (5%).

• Oxford Nanopore sequencing allowed for high-throughput, cost-effective genotyping and detection of resistance mutations, even in samples with a low viral load which proved challenging for other methods.

Sample type: human blood plasma

Kit: Rapid Barcoding Kit