The Magnitude and Patterns of Acquired Drug Resistance Mutations and Circulating HIV-1 Subtypes in HIV Patients in Tanzania, a Systematic Review and Meta-Analysis

• Published in: Viruses Vol. 17; no. 8; p. 1087
• Main Authors: Henerico, Shimba, Kasang, Christa, Kidenya, Benson R., Sabas, Deodatus, Kajogoo, Violet D., Van Zyl, Gert, Preiser, Wolfgang, Mshana, Stephen E., Kalluvya, Samuel E.
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 06.08.2025; MDPI
• Subjects: Acquired immune deficiency syndrome; AIDS; Analysis; Anti-HIV agents; Anti-HIV Agents - pharmacology; Anti-HIV Agents - therapeutic use; Antiretroviral therapy; Antiviral agents; Asymmetry; Bias; Cross-sectional studies; Drug resistance; Drug Resistance, Viral - genetics; Genotype; HIV; HIV (Viruses); HIV drug resistance; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - virology; HIV-1 - classification; HIV-1 - drug effects; HIV-1 - genetics; HIV-1 subtypes; Human immunodeficiency virus; Humans; Medical research; Medicine, Experimental; Meta-analysis; Mortality; Mutation; Non-nucleoside reverse transcriptase inhibitors; Pandemics; Prevalence; Public health; Reverse transcriptase inhibitors; Systematic Review; systematic review and meta-analysis; Tanzania; Tanzania - epidemiology; Tanzania; HIV-1 subtypes; HIV drug resistance; Tanzania; systematic review and meta-analysis
• ISSN: 1999-4915; 1999-4915
• DOI: 10.3390/v17081087

The emergence and spread of HIV drug resistance mutations (DRMs) pose a threat to current and future treatment options. To inform policy, this review aimed to determine the magnitude and patterns of DRMs in patients on ART in Tanzania. A systematic literature search was conducted in MEDLINE through PubMed, Embase, and CINAHL up to December 2024. A total of 9685 HIV patients from 23 eligible studies were analyzed. The prevalence of virological failure in studies that used a threshold of >1000 and >400 copies/mL was 24.83% (95% CI: 17.85–32.53%) and 36.94% (95% CI: 24.79–50.00%), respectively. Major DRMs were observed at 87.61% (95% CI: 76.25–95.91%). A decrease in prevalence was observed in studies conducted from 2019, with a pooled prevalence of 62.15% (95% CI: 31.57–88.33%). The most frequently observed HIV-1 subtypes were subtype C at 36.20% (95% CI: 30.71–41.85%), A1 at 33.13% (95% CI: 28.23–38.20%), and subtype D at 16.00% (95% CI: 11.41–21.12%), while recombinant forms of the virus were observed at 13.29% (95% CI: 9.79–17.17%). The prevalence of DRMs against NRTIs and NNRTIs was significantly high, while that against INSTIs and PIs was low, supporting the continued use of PI- and INSTI-based regimens in Tanzania and the need for continued surveillance of DRMs.