Publication

Title: Increasing HIV-1 drug resistance between 2010 and 2012 in adults participating in population-based HIV surveillance in rural KwaZulu-Natal South Africa
Authors: Manasa J, Danaviah S, Lessells RJ, Elshareef M, Tanser F, Wilkinson E, Pillay S, Mthiyane H, Mwambi H, Pillay D, de Oliveira T.
Journal: AIDS Res Hum Retroviruses,32(8):763-769 (2016)

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Abstract

Background As more HIV-infected patients access combination antiretroviral therapy (cART), higher proportions of newly infected patients may be infected with drug-resistant viruses. Regular surveillance of transmitted drug resistance (TDR) is required in southern Africa where high rates of transmission persist despite rapid expansion of ART.

MethodsDried blood spot (DBS) samples from cART-naive participants from two rounds of an annual population based HIV surveillance programme in rural KwaZulu-Natal underwent HIV RNA testing and samples with HIV RNA >10 000 copies/ml were genotyped for drug resistance. The 2009 Surveillance of drug resistance mutations (SDRM) list was used for drug resistance interpretation. The data was added to previously published data from the same programme and the Chi-square (?2) test for trend was used to test for trend in estimated prevalence of any transmitted drug resistance.

Results701 participant's data were analyzed: 67 (2010), 381(2011), and 253 (2012). No TDR was detected in 2010. 2011 and 2012 both had 18 participants with SDRMs, 4.7% and 7.1% respectively (p = 0.02, X2 test for trend). The non-nucleoside reverse-transcriptase inhibitor mutation, K103N was the most common mutation, occurring in 27 (3.8%) while nucleoside reverse-transcriptase inhibitor (NRTI) SDRMs were detected in ten (1.4%) of the participants, of whom eight had only a single NRTI SDRM.

ConclusionsThe increase in levels of drug resistance observed in this population could be a signal of increasing transmission of drug-resistant HIV. Thus continued surveillance is critical to inform public health policies around HIV treatment and prevention.

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Citation: Manasa J, Danaviah S, Lessells RJ, Elshareef M, Tanser F, Wilkinson E, Pillay S, Mthiyane H, Mwambi H, Pillay D, de Oliveira T. Increasing HIV-1 drug resistance between 2010 and 2012 in adults participating in population-based HIV surveillance in rural KwaZulu-Natal South Africa AIDS Res Hum Retroviruses,32(8):763-769 (2016).