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Four-class drug-resistant HIV-1 subtype C in a treatment experienced individual on dolutegravir-based antiretroviral therapy in Botswana

Seatla, Kaelo K.a,b,f; Avalos, Avad,f,h; Moyo, Sikhulilea,e; Mine, Madisaa,d; Diphoko, Thaboa,b; Mosepele, Mosepelea,c,f; Gaolatlhe, Tendania,c; Rowley, Christopher F.e; Ramaabya, Dinahd; Jarvis, Joseph N.a,c,f,g; Kasvosve, Ishmaelb; Gaseitsiwe, Simania,e

doi: 10.1097/QAD.0000000000001920
Research Letter

There are limited data on the effectiveness of dolutegravir (DTG)-based combination antiretroviral therapy (ART) in real-life settings in southern Africa where HIV-1 subtype C predominates. We report a patient infected with HIV-1 subtype C on DTG-based ART previously exposed to raltegravir who developed multidrug resistance mutations to four antiretroviral classes. There is need for drug resistance monitoring and clinical vigilance to ensure effectiveness of HIV treatment programs even in the era of DTG-based ART.

aBotswana Harvard AIDS Institute Partnership

bDepartment of Medical Laboratory Sciences, Faculty of Health Sciences

cDepartment of Medicine, Faculty of Medicine, University of Botswana

dMinistry of Health and Wellness, Gaborone, Botswana

eDepartment of Immunology & Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA

fInfectious Disease Care Clinic, Princess Marina Hospital, Gaborone, Botswana

gDepartment of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK

hCareena Centre for Health, Gaborone, Botswana.

Correspondence to Dr Kaelo K. Seatla, MBBS, DTMH, Botswana Harvard AIDS Institute Partnership, Private Bag BO320, Bontleng, Gaborone, Botswana. Tel: +267 390 2671; fax: +267 390 1284; e-mail:,

Received 15 April, 2018

Revised 7 May, 2018

Accepted 31 May, 2018

Copyright © 2018 Wolters Kluwer Health, Inc.