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Rutendo Gutsire, MSc, MPH, PhD

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GHES LMIC Fellow 2019-2020

FELLOWSHIP SITE: University of Zimbabwe
U.S. INSTITUTION: Stanford University

Project Title: Validation of the Oligonucleotide Ligation Assay (OLA) HIV Drug Resistance kit Amongst HIV Positive Research Study Participants, Harare, Zimbabwe.

Zimbabwe is one of the Southern African countries with a high HIV prevalence 13% and many people who are testing and being initiated on ART as per the 2016 WHO recommendations of test and treat.  Available research shows that some people who start on ART develop drug resistance. There is limited access to HIV/DR in most resource limited settings including Zimbabwe because most available methods and kits are very expensive and involve complex procedures, hence the need for simpler low cost methods like OLA.   The main aim of this sub-study is therefore the validation of the latest improved multiplex OLA HIV DR kit and assess feasibility of its adaptation for use in Zimbabwe as a point of care (POC) testing kit and determination of factors associated with development of HIV drug resistance amongst the men and women recruited into the currently ongoing research studies in Harare, Zimbabwe.

The research team led by Dr Lisa Frenkel, University of Washington and Seattle Children’s Research Institute, Seattle, have developed and have continued to modify a low cost OLA HIV drug resistance testing kit suitable for use in low resource settings.  The Muliplex OLA kit can detect HIV drug resistance to multiple ARVs simultaneously.

Rationale

HIV drug resistance remains a major public health concern in Zimbabwe as we now have a huge number of HIV positive patients on ART (Zimbabwe 2016 ART guidelines).  There is therefore urgent need to validate available low cost HIV drug resistance kits among those HIV infected in the Zimbabwean population and recommend their adoption as point of care testing tools.  

Main objective

To validate the OLA HIV DR kit against conventional sequencing methods and determining the factors contributing to HIV drug resistance amongst HIV positive research participants enrolled into ongoing research studies in Harare, Zimbabwe.

Specific objectives

  1. To validate the OLA HIV drug resistance kit for use in Zimbabwe in   

            comparison to the CDC/Thermofisher and Next Generation Sequencing (NGS).

  1. To determine the prevalence of HIV drug resistance amongst HIV positive participants from the three selected research studies.

  2. To determine the factors contributing to HIV drug resistance amongst these research participants.

  3. To carry out a cost benefit analysis of HIV DR testing with OLA

          compared to the CDC/Thermofisher method and Next Generation

          Sequencing (NGS).