Drug resistance in HIV's interaction with reverse transcriptase and integrase strand transfer inhibitors among Nigerians attending a military hospital

Background: Human Immunodeficiency Virus (HIV) is a complex and dynamic virus that interacts with various cellular components and pathways, leading to the development of antiretroviral therapy (ART) resistance. One of the key factors contributing to ART resistance is the toxicity and inflammatory response associated with the virus's interaction with reverse transcriptase and integrase strand transfer inhibitors. The study aimed to assess circulating strains of HIV in relation to drug resistance among clients on tenofovir lamivudine dolutegravir (TLD) attending Nigerian Navy Hospital (NNH) Warri. Methods:  This was a cross-sectional study in which 120 HIV seropositive subjects, aged 18-65 were recruited through simple random sampling, and data was collected via semi-structured interviews. Five milliliters of venous blood were collected from each participant and plasma separation was done by centrifugation. Immuno-chromatographic Lateral Flow Assay and real-time PCR assay were employed for HIV strain typing and viral load estimation, respectively. Statistical analysis was conducted using Epi-info Statistical Software version 7.2, with significance set at p < 0.05. Results: The mean age of participants was 38.4±11.1 years and 68(56.7%) were females. Majority of the participants 41(34.2%) belonged to age group 41-50 years and 57(47.5%) were married. Most of the participants 107 (89.1%) had HIV-1 and 11(9.2%) had HIV-2 while only 2(1.7%) were having co-infection with HIV 1 and 2. Viral load was undetected in 48(40%) of the subjects and 64(53.3%) had suppressed viral load (≤1000 copies/ml) while 8(6.7%) had unsuppressed viral load (>1000 copies/ml). All subjects with unsuppressed viral load had HIV-1 with a mean age of 39.6±13.1 years and 4(50%) were male.  Conclusion: Our study highlights the prevalence of unsuppressed viral load in HIV-1-infected individuals on TLD at NNH Warri. Addressing drug resistance concerns remains crucial for effective antiretroviral therapy management. Clients with unsuppression were recommended for enhanced adherence counseling to diagnose treatment failure.