@article{fdi:010072435,
  title = {{HIV}-1 drug resistance before initiation or re-initiation of first-line antiretroviral therapy in low-income and middle-income countries : a systematic review and meta-regression analysis},
  author = {{G}upta, {R}. {K}. and {G}regson, {J}. and {P}arkin, {N}. and {H}aile-{S}elassie, {H}. and {T}anuri, {A}. and {F}orero, {L}. {A}. and {K}aleebu, {P}. and {W}atera, {C}. and {A}ghokeng {F}obang, {A}velin and {M}utenda, {N}. and {D}zangare, {J}. and {H}one, {S}. and {H}ang, {Z}. {Z}. and {G}arcia, {J}. and {G}arcia, {Z}. and {M}archorro, {P}. and {B}eteta, {E}. and {G}iron, {A}. and {H}amers, {R}. and {I}nzaule, {S}. and {F}renkel, {L}. {M}. and {C}hung, {M}. {H}. and de {O}liveira, {T}. and {P}illay, {D}. and {N}aidoo, {K}. and {K}harsany, {A}. and {K}ugathasan, {R}. and {C}utino, {T}. and {H}unt, {G}. and {R}ios, {S}. {A}. and {D}oherty, {M}. and {J}ordan, {M}. {R}. and {B}ertagnolio, {S}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {P}retreatment drug resistance in people initiating or re-initiating antiretroviral therapy ({ART}) containing non-nucleoside reverse transcriptase inhibitors ({NNRTI}s) might compromise {HIV} control in low-income and middle-income countries ({LMIC}s). {W}e aimed to assess the scale of this problem and whether it is associated with the intiation or re-initiation of {ART} in people who have had previous exposure to antiretroviral drugs. {M}ethods {T}his study was a systematic review and meta-regression analysis. {W}e assessed regional prevalence of pretreatment drug resistance and risk of pretreatment drug resistance in people initiating {ART} who reported previous {ART} exposure. {W}e systematically screened publications and unpublished datasets for pretreatment drug-resistance data in individuals in {LMIC}s initiating or re-initiating first-line {ART} from {LMIC}s. {W}e searched for studies in {P}ub{M}ed and {E}mbase and conference abstracts and presentations from the {C}onference on {R}etroviruses and {O}pportunistic {I}nfections, the {I}nternational {AIDS} {S}ociety {C}onference, and the {I}nternational {D}rug {R}esistance {W}orkshop for the period {J}an 1, 2001, to {D}ec 31, 2016. {T}o assess the prevalence of drug resistance within a specified region at any specific timepoint, we extracted study level data and pooled prevalence estimates within the region using an empty logistic regression model with a random effect at the study level. {W}e used random effects meta-regression to relate sampling year to prevalence of pretreatment drug resistance within geographical regions. {F}indings {W}e identified 358 datasets that contributed data to our analyses, representing 56 044 adults in 63 countries. {P}revalence estimates of pretreatment {NNRTI} resistance in 2016 were 11.0% (7.5-15.9) in southern {A}frica, 10.1% (5.1-19.4) in eastern {A}frica, 7.2% (2.9-16.5) in western and central {A}frica, and 9.4% (6.6-13.2) in {L}atin {A}merica and the {C}aribbean. {T}here were substantial increases in pretreatment {NNRTI} resistance per year in all regions. {T}he yearly increases in the odds of pretreatment drug resistance were 23% (95% {CI} 16-29) in southern {A}frica, 17% (5-30) in eastern {A}frica, 17% (6-29) in western and central {A}frica, 11% (5-18) in {L}atin {A}merica and the {C}aribbean, and 11% (2-20) in {A}sia. {E}stimated increases in the absolute prevalence of pretreatment drug resistance between 2015 and 2016 ranged from 0.3% in {A}sia to 1.8% in southern {A}frica. {I}nterpretation {P}retreatment drug resistance is increasing at substantial rate in {LMIC}s, especially in sub-{S}aharan {A}frica. {I}n 2016, the prevalence of pretreatment {NNRTI} resistance was near {WHO}'s 10% threshold for changing first-line {ART} in southern and eastern {A}frica and {L}atin {A}merica, underscoring the need for routine national {HIV} drug-resistance surveillance and review of national policies for first-line {ART} regimen composition.},
  keywords = {{AFRIQUE} {SUBSAHARIENNE} ; {ASIE} ; {AMERIQUE} {LATINE} ; {CARRAIBE} ; {PAYS} {EN} {DEVELOPPEMENT}},
  booktitle = {},
  journal = {{L}ancet {I}nfectious {D}iseases},
  volume = {18},
  numero = {3},
  pages = {346--355},
  ISSN = {1473-3099},
  year = {2018},
  DOI = {10.1016/s1473-3099(17)30702-8},
  URL = {https://www.documentation.ird.fr/hor/fdi:010072435},
}