International Journal of Infectious Diseases (Aug 2024)
Clinical, molecular, and drug resistance epidemiology of HIV in Jordan, 2019-2021: A national study
- Faris G. Bakri,
- Heyam H. Mukattash,
- Hiam Esmeiran,
- Glenna Schluck,
- Casey K. Storme,
- Erica Broach,
- Tsedal Mebrahtu,
- Mohammad Alhawarat,
- Anais Valencia-Ruiz,
- Oussama M'Hamdi,
- Jennifer A. Malia,
- Zebiba Hassen,
- Mah'd M.S. Shafei,
- Ala Y. Alkhatib,
- Mahmoud Gazo,
- Saied A. Jaradat,
- Yessenia Gomez,
- Samantha McGeehon,
- Melanie D. McCauley,
- Sarah C. Moreland,
- Janice M. Darden,
- Mihret Amare,
- Trevor A. Crowell,
- Sandhya Vasan,
- Nelson L. Michael,
- Julie A. Ake,
- Kayvon Modjarrad,
- Paul T. Scott,
- Sheila A. Peel,
- Shilpa Hakre
Affiliations
- Faris G. Bakri
- Division of Infectious Diseases, Department of Internal Medicine, Jordan University Hospital, Amman, Jordan; Infectious Diseases and Vaccine Center, University of Jordan, Amman, Jordan
- Heyam H. Mukattash
- Primary Health Care Directorate, Ministry of Health, Amman, Jordan
- Hiam Esmeiran
- HJF Medical Research International (HJFMRI), Amman, Jordan
- Glenna Schluck
- 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
- Casey K. Storme
- 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
- Erica Broach
- 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
- Tsedal Mebrahtu
- 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
- Mohammad Alhawarat
- Communicable Diseases Directorate, Ministry of Health, Amman, Jordan
- Anais Valencia-Ruiz
- 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
- Oussama M'Hamdi
- 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
- Jennifer A. Malia
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD
- Zebiba Hassen
- 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
- Mah'd M.S. Shafei
- Central Public Health Laboratory, Ministry of Health, Amman, Jordan
- Ala Y. Alkhatib
- Voluntary Counselling and Testing Center, Ministry of Health, Amman, Jordan
- Mahmoud Gazo
- Central Public Health Laboratory, Ministry of Health, Amman, Jordan
- Saied A. Jaradat
- Princess Haya Biotechnology Center, Jordan University of Science and Technology, Irbid, Jordan
- Yessenia Gomez
- 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
- Samantha McGeehon
- 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
- Melanie D. McCauley
- 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
- Sarah C. Moreland
- 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
- Janice M. Darden
- 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
- Mihret Amare
- 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
- Trevor A. Crowell
- 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
- Sandhya Vasan
- 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
- Nelson L. Michael
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD
- Julie A. Ake
- United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD
- Kayvon Modjarrad
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD
- Paul T. Scott
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD
- Sheila A. Peel
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD
- Shilpa Hakre
- 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; Corresponding author. Shilpa Hakre, Emerging Infectious Diseases Branch, 6720-A Rockledge Drive, Suite 400, Bethesda, MD 20817.
- Journal volume & issue
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Vol. 145
p. 107079
Abstract
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.
