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No increase of drug-resistant HIV type 1 prevalence among drug-naive individuals in Northern Vietnam.

ABSTRACT: We reported previously that the prevalence of drug-resistant HIV-1 among antiretroviral therapy (ART)-naive individuals in Northern Vietnam was 2.9% in 2007 and 6.2% in 2008. To investigate the continuing trend of prevalence, we collected plasma samples from 958 individuals in Hai Phong and Hanoi in 2009, extracted viral RNA from HIV-1 antibody-positive samples, and analyzed them genetically. HIV-1 antibody prevalence was 26.8% in injecting drug users (n=302), 13.4% in female sex workers (n=284), 0.5% in blood donors (n=206), and 0.6% in pregnant women (n=166). All HIV-1 strains were CRF01_AE. Nonnucleoside reverse-transcriptase inhibitor resistance mutations were found in two (2.0%) of the 102 successfully analyzed cases (one case with the Y181C and one with the K101E). No nucleoside reverse-transcriptase inhibitor resistance or protease inhibitor resistance mutations were detected. The prevalence of circulating ART-resistant HIV-1 in Northern Vietnam did not increase from 2007 to 2009, although the rate of ART coverage did increase.

SUBMITTER: Tran VT

PROVIDER: S-EPMC3448096 | biostudies-literature | 2012 Oct

REPOSITORIES: biostudies-literature

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No increase of drug-resistant HIV type 1 prevalence among drug-naive individuals in Northern Vietnam.

Tran Vuong Thi VT Ishizaki Azumi A Nguyen Cuong Hung CH Hoang Huyen Thi Thanh HT Pham Hung Viet HV Bi Xiuqiong X Van Pham Thuc T Ichimura Hiroshi H

AIDS research and human retroviruses 20120306 10

We reported previously that the prevalence of drug-resistant HIV-1 among antiretroviral therapy (ART)-naive individuals in Northern Vietnam was 2.9% in 2007 and 6.2% in 2008. To investigate the continuing trend of prevalence, we collected plasma samples from 958 individuals in Hai Phong and Hanoi in 2009, extracted viral RNA from HIV-1 antibody-positive samples, and analyzed them genetically. HIV-1 antibody prevalence was 26.8% in injecting drug users (n=302), 13.4% in female sex workers (n=284) ...[more]

PMID: 22264087

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Project description:BackgroundSurveillance of drug resistance in antiretroviral treatment-naïve patients in China is needed to ensure optimal treatment outcomes and control of the human immunodeficiency virus (HIV) epidemic.MethodsA systematic literature search was conducted in English and Chinese through PubMed (English), China National Knowledge Infrastructure (Chinese), Chinese Biomedical Literature Database (Chinese), and Wanfang (Chinese). Random effects models were used to calculate the pooled prevalence of transmitted drug resistance and subgroup analyses examined prevalence estimates across time periods, study locations, and study populations.ResultsAnalysis of data from 71 studies (47 in Chinese and 24 in English) yielded a pooled prevalence of transmitted HIV drug resistance to any antiretroviral drug class of 3.64% (95% confidence interval [CI]: 3.00%-4.32%). Rates were significantly high at initial stage of free ART program from 2003 to 2005 (5.18%, 95%CI: 3.13%-7.63%), and were much lower among studies conducted in 2006-2008 (3.02%, 95%CI: 2.03%-4.16%). A slight increase was observed again in the most recent study period from 2009 to 2012 (3.68%, 95%CI: 2.78%-4.69%). Subgroup analysis revealed highest prevalence levels of transmitted drug resistance in Beijing city, and Henan and Hubei provinces (above 5%), and although differences in prevalence rates among risk groups were negligible, men who have sex with men were unique in their relatively large portion of protease inhibitor resistance, a second-line drug of limited availability in China.ConclusionsOverall prevalence of transmitted HIV drug resistance in China is classified as "low" by the World Health Organization. However regional and temporal variability suggest a more complex epidemic for which closer HIV drug resistance surveillance is needed. A nationwide HIV drug resistance surveillance system to monitor both treatment-experienced and treatment-naïve patients will be a cornerstone to ensure the effectiveness of treatment scale-up, particularly as China seeks to expand a national policy of antiretroviral treatment as prevention.

Project description:In Brazil, more than 487,450 individuals are currently undergoing antiretroviral treatment. In order to monitor the transmission of drug-resistant strains and HIV subtype distribution in the country, this work aimed to estimate its prevalence and to characterize the nationwide pretreatment drug resistance in individuals recently diagnosed with HIV between 2013 and 2015. The HIV threshold survey methodology (HIV-THS, WHO) targeting antiretroviral-naive individuals with recent HIV diagnosis was utilized, and subjects were selected from 51 highly populated cities in all five Brazilian macroregions. The HIV pol genotypic test was performed by genomic sequencing. We analysed samples from 1568 antiretroviral-naive individuals recently diagnosed with HIV, and the overall transmitted drug resistance (TDR) prevalence was 9.5% (150 sequences). The regional prevalence of resistance according to Brazilian geographical regions was 9.4% in the northeast, 11.2% in the southeast, 6.8% in the central region, 10.2% in the north and 8.8% in the south. The inhibitor-specific TDR prevalence was 3.6% for nucleoside reverse transcriptase inhibitors (NRTIs), 5.8% for non-nucleoside reverse transcriptase inhibitors (NNRTIs) and 1.6% for protease inhibitors (PIs); 1.0% of individuals presented resistance to more than one class of inhibitors. Overall, subtype B was more prevalent in every region except for the southern, where subtype C prevails. To the best of our knowledge, this is the first TDR study conducted in Brazil with nationwide representative sampling. The TDR prevalence revealed a moderate rate in the five Brazilian geographical regions, although some cities presented higher TDR prevalence rates, reaching 14% in São Paulo, for example. These results further illustrate the importance of surveillance studies for designing future strategies in primary antiretroviral therapy, aiming to mitigate TDR, as well as for predicting future trends in other regions of the globe where mass antiretroviral (ARV) treatment was implemented.

Project description:ObjectivesSurveillance drug resistance mutations (SDRMs) in drug-naive patients are typically used to survey HIV-1-transmitted drug resistance (TDR). We test here how SDRMs in patients failing treatment, the original source of TDR, contribute to assessing TDR, transmissibility and transmission source of SDRMs.DesignThis is a retrospective observational study analyzing a Portuguese cohort of HIV-1-infected patients.MethodsThe prevalence of SDRMs to protease inhibitors, nucleoside reverse transcriptase inhibitors (NRTIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs) in drug-naive and treatment-failing patients was measured for 3554 HIV-1 subtype B patients. Transmission ratio (prevalence in drug-naive/prevalence in treatment-failing patients), average viral load and robust linear regression with outlier detection (prevalence in drug-naive versus in treatment-failing patients) were analyzed and used to interpret transmissibility.ResultsPrevalence of SDRMs in drug-naive and treatment-failing patients were linearly correlated, but some SDRMs were classified as outliers - above (PRO: D30N, N88D/S, L90?M, RT: G190A/S/E) or below (RT: M184I/V) expectations. The normalized regression slope was 0.073 for protease inhibitors, 0.084 for NRTIs and 0.116 for NNRTIs. Differences between SDRMs transmission ratios were not associated with differences in viral loads.ConclusionThe significant linear correlation between prevalence of SDRMs in drug-naive and in treatment-failing patients indicates that the prevalence in treatment-failing patients can be useful to predict levels of TDR. The slope is a cohort-dependent estimate of rate of TDR per drug class and outlier detection reveals comparative persistence of SDRMs. Outlier SDRMs with higher transmissibility are more persistent and more likely to have been acquired from drug-naive patients. Those with lower transmissibility have faster reversion dynamics after transmission and are associated with acquisition from treatment-failing patients.

Dataset Information

No increase of drug-resistant HIV type 1 prevalence among drug-naive individuals in Northern Vietnam.

Publications

No increase of drug-resistant HIV type 1 prevalence among drug-naive individuals in Northern Vietnam.

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