HIV‐1 Genetic Diversity and Drug Resistance Mutations Among Patients on Antiretroviral Therapy in Nairobi County, Kenya

Kenya, a country with a significant number of human immunodeficiency virus type 1 (HIV‐1) infected individuals, has adopted the World Health Organization’s (WHO’s) “test and treat all” strategy to reduce HIV‐related deaths and new infections, aligning with the United Nations’ Acquired Immune Deficiency Syndrome (UNAIDS) 95‐95‐95 targets. In 2019, Kenya adopted the WHO’s first‐line antiretroviral Therapy (ART) recommendations, which include tenofovir/lamivudine/dolutegravir (TDF + 3TC + DTG) as a cost‐effective regimen. Despite these efforts, new HIV infections and AIDS‐related mortality continue in developing countries. This cross‐sectional study investigated HIV‐1 drug resistance mutations and subtypes among patients receiving ART in Nairobi County, Kenya. The study enrolled 227 HIV‐1‐infected patients for 12 months, with 42 out of the total 227 samples successfully amplified by polymerase chain reaction (PCR). HIV‐1 genotypic drug resistance was determined using an in‐house sequencing method. Sociodemographic data were analyzed using descriptive statistics to summarize and describe the key characteristics of the dataset. The Stanford University HIV Drug Resistance algorithm was used to analyze drug resistance mutations, and phylogenetic analysis with MEGA 11 software assessed HIV‐1 genetic diversity. The study identified key HIV‐1 drug resistance mutations, including M184V (13.73%), K103N (9.8%), Y181C (4.9%), T215Y (4.9%), and D67N (4.9%). Phylogenetic analysis of the 42 sequences generated from the study demonstrated significant genetic diversity, with Subtype A being the most dominant at 69%, followed by Subtype D (23.8%), Subtype C (4.8%), and CRF10_CD (2.4%). This study provides crucial insights into the distribution of HIV‐1 genotypes and the incidence of drug‐resistance mutations among HIV‐1 patients in Nairobi. These findings provide critical insights to guide policymakers and healthcare providers in optimizing the management and treatment of HIV‐1 patients undergoing ART.