Cohort profile: the pharmacogenomics and pharmacokinetics study in Ghanaian HIV patients (GenoPharm-GH).

BACKGROUND: The GenoPharm-GH project initiated in 2019, as a longitudinal, multi-site observational cohort study aimed at bridging gaps in understanding the influence of host genetics, pharmacokinetics and comorbidities on treatment outcome among persons living with HIV (PLWH) in Ghana. METHODS: The study is ongoing prospective, longitudinal, multi-site cohort associated with diverse projects being conducted throughout health facilities across Ghana. So far 2044 persons living with HIV (PLWH) aged ≥ 8 years have been registered. These participants are on treatment with antiretroviral therapies (ART). Viral suppression, treatment adherence (self-reported and pill count), clinical data, genetic variations, coinfections, and comorbidities are being studied among these participants. Samples from the studies have been stored in the biorepository in the PGMG laboratory. RESULTS: Among the cohort, ≥ 95% are on dolutegravir-based ART; 58% have viral loads less than 50 copies/mL at the latest visit with approximately 10-15% in virologic failure (> 1000cp/mL). Drug metabolite profiling has been undertaken for dolutegravir in mono infections and coinfections with malaria. Pharmacogenetics data for CYP3A4, CYP3A5, UGT1A1 and ApoE have been determined in sub-studies. Coinfections and other non-communicable diseases observed include hepatitis B and C, tuberculosis, pneumonia, diabetes and hypertension indicating the need for integrated care strategies for PLWH. A biorepository has been created for sub-studies and future analysis. CONCLUSIONS: The project provides a strong avenue for translational HIV research, guiding policy and enhancing long-term results. Expanding biobanking and ongoing follow-up should help to improve knowledge of treatment outcomes, support individualised HIV treatment, and direct further therapeutic interventions. Participants are followed up and data updated at regular intervals to understand the dynamics of treatment outcome.