Surveillance of HIV-1 Pol Transmitted Drug Resistance in Acutely and Recently Infected Antiretroviral Drug-Naïve Persons in Eural Western Kenya

Hdl Handle:
http://hdl.handle.net/10144/618808
Title:
Surveillance of HIV-1 Pol Transmitted Drug Resistance in Acutely and Recently Infected Antiretroviral Drug-Naïve Persons in Eural Western Kenya
Authors:
Onywera, H; Maman, D; Inzaule, S; Auma, E; Were, K; Fredrick, H; Owiti, P; Opollo, V; Etard, JF; Mukui, I; Kim, AA; Zeh, C
Journal:
PLoS One
Abstract:
HIV-1 transmitted drug resistance (TDR) is of increasing public health concern in sub-Saharan Africa with the rollout of antiretroviral (ARV) therapy. Such data are, however, limited in Kenya, where HIV-1 drug resistance testing is not routinely performed. From a population-based household survey conducted between September and November 2012 in rural western Kenya, we retrospectively assessed HIV-1 TDR baseline rates, its determinants, and genetic diversity among drug-naïve persons aged 15-59 years with acute HIV-1 infections (AHI) and recent HIV-1 infections (RHI) as determined by nucleic acid amplification test and both Limiting Antigen and BioRad avidity immunoassays, respectively. HIV-1 pol sequences were scored for drug resistance mutations using Stanford HIVdb and WHO 2009 mutation guidelines. HIV-1 subtyping was computed in MEGA6. Eighty seven (93.5%) of the eligible samples were successfully sequenced. Of these, 8 had at least one TDR mutation, resulting in a TDR prevalence of 9.2% (95% CI 4.7-17.1). No TDR was observed among persons with AHI (n = 7). TDR prevalence was 4.6% (95% CI 1.8-11.2) for nucleoside reverse transcriptase inhibitors (NRTIs), 6.9% (95% CI 3.2-14.2) for non- nucleoside reverse transcriptase inhibitors (NNRTIs), and 1.2% (95% CI 0.2-6.2) for protease inhibitors. Three (3.4% 95% CI 0.8-10.1) persons had dual-class NRTI/NNRTI resistance. Predominant TDR mutations in the reverse transcriptase included K103N/S (4.6%) and M184V (2.3%); only M46I/L (1.1%) occurred in the protease. All the eight persons were predicted to have different grades of resistance to the ARV regimens, ranging from potential low-level to high-level resistance. HIV-1 subtype distribution was heterogeneous: A (57.5%), C (6.9%), D (21.8%), G (2.3%), and circulating recombinant forms (11.5%). Only low CD4 count was associated with TDR (p = 0.0145). Our findings warrant the need for enhanced HIV-1 TDR monitoring in order to inform on population-based therapeutic guidelines and public health interventions.
Publisher:
Public Library of Science
Issue Date:
8-Feb-2017
URI:
http://hdl.handle.net/10144/618808
DOI:
10.1371/journal.pone.0171124
PubMed ID:
28178281
Submitted date:
2017-02-27
Language:
en
ISSN:
1932-6203
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorOnywera, Hen
dc.contributor.authorMaman, Den
dc.contributor.authorInzaule, Sen
dc.contributor.authorAuma, Een
dc.contributor.authorWere, Ken
dc.contributor.authorFredrick, Hen
dc.contributor.authorOwiti, Pen
dc.contributor.authorOpollo, Ven
dc.contributor.authorEtard, JFen
dc.contributor.authorMukui, Ien
dc.contributor.authorKim, AAen
dc.contributor.authorZeh, Cen
dc.date.accessioned2017-02-28T21:17:48Z-
dc.date.available2017-02-28T21:17:48Z-
dc.date.issued2017-02-08-
dc.date.submitted2017-02-27-
dc.identifier.citationSurveillance of HIV-1 Pol Transmitted Drug Resistance in Acutely and Recently Infected Antiretroviral Drug-Naïve Persons in Eural Western Kenya. 2017, 12 (2):e0171124 PLoS ONEen
dc.identifier.issn1932-6203-
dc.identifier.pmid28178281-
dc.identifier.doi10.1371/journal.pone.0171124-
dc.identifier.urihttp://hdl.handle.net/10144/618808-
dc.description.abstractHIV-1 transmitted drug resistance (TDR) is of increasing public health concern in sub-Saharan Africa with the rollout of antiretroviral (ARV) therapy. Such data are, however, limited in Kenya, where HIV-1 drug resistance testing is not routinely performed. From a population-based household survey conducted between September and November 2012 in rural western Kenya, we retrospectively assessed HIV-1 TDR baseline rates, its determinants, and genetic diversity among drug-naïve persons aged 15-59 years with acute HIV-1 infections (AHI) and recent HIV-1 infections (RHI) as determined by nucleic acid amplification test and both Limiting Antigen and BioRad avidity immunoassays, respectively. HIV-1 pol sequences were scored for drug resistance mutations using Stanford HIVdb and WHO 2009 mutation guidelines. HIV-1 subtyping was computed in MEGA6. Eighty seven (93.5%) of the eligible samples were successfully sequenced. Of these, 8 had at least one TDR mutation, resulting in a TDR prevalence of 9.2% (95% CI 4.7-17.1). No TDR was observed among persons with AHI (n = 7). TDR prevalence was 4.6% (95% CI 1.8-11.2) for nucleoside reverse transcriptase inhibitors (NRTIs), 6.9% (95% CI 3.2-14.2) for non- nucleoside reverse transcriptase inhibitors (NNRTIs), and 1.2% (95% CI 0.2-6.2) for protease inhibitors. Three (3.4% 95% CI 0.8-10.1) persons had dual-class NRTI/NNRTI resistance. Predominant TDR mutations in the reverse transcriptase included K103N/S (4.6%) and M184V (2.3%); only M46I/L (1.1%) occurred in the protease. All the eight persons were predicted to have different grades of resistance to the ARV regimens, ranging from potential low-level to high-level resistance. HIV-1 subtype distribution was heterogeneous: A (57.5%), C (6.9%), D (21.8%), G (2.3%), and circulating recombinant forms (11.5%). Only low CD4 count was associated with TDR (p = 0.0145). Our findings warrant the need for enhanced HIV-1 TDR monitoring in order to inform on population-based therapeutic guidelines and public health interventions.en
dc.language.isoenen
dc.publisherPublic Library of Scienceen
dc.rightsPublished by Public Library of Science, [url]http://www.plosone.org/[/url] Archived on this site by Open Access permissionen
dc.titleSurveillance of HIV-1 Pol Transmitted Drug Resistance in Acutely and Recently Infected Antiretroviral Drug-Naïve Persons in Eural Western Kenyaen
dc.identifier.journalPLoS Oneen

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