Transmitted drug resistance and type of infection in newly diagnosed HIV-1 individuals in Honduras |
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Affiliation: | 1. Microbiology Department, National Autonomous University of Honduras (UNAH), Tegucigalpa, Honduras;2. Department of Virology, Swedish Institute for Infectious Disease Control (SMI), Stockholm, Sweden;3. Department of Microbiology, Cell and Tumor Biology, Karolinska Institute (KI), Stockholm, Sweden;4. Tephinet, Inc., Atlanta, GA, USA;5. Del Valle University of Guatemala, Guatemala City, Guatemala;6. Division of Global AIDS. Centers for Disease Control and Prevention (CDC). Atlanta, GA, USA;7. HIV/AIDS National Program, Secretaría de Salud de Honduras. Tegucigalpa, Honduras;1. Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa;2. University of KwaZulu-Natal, Durban, South Africa;3. Africa Centre for Population Health, Hlabisa, South Africa;4. Epicentre, Durban, South Africa;5. National Institute for Communicable Diseases, Johannesburg, South Africa;6. Global Clinical and Virology Laboratory, Durban, South Africa;7. Department of Epidemiology, Columbia University, New York, NY, USA;1. Mortimer Market Centre, Central and North West London NHS Foundation Trust, London WC1E 6JB, England, UK;2. Clinical Microbiology and Virology, University College London NHS Foundation Trust, London W1T 4EU, England, UK;3. Illumina Cambridge Ltd, Chesterford Research Park, Little Chesterford, Cambridge CB10 1XL, England, UK;4. Royal Free London NHS Foundation Trust, London NW3 2QG, England, UK;1. Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Universidad de Buenos Aires, Argentina;2. Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina;3. Laboratorio de Virología y Genética Molecular, Facultad de Ciencias Naturales sede Trelew, Universidad Nacional de la Patagonia San Juan Bosco, Chubut, Argentina;1. Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand;2. Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections (RCC-ERI), Nonthaburi, Thailand;3. Research Institute for Microbial Diseases, Osaka University, Osaka, Japan;4. Department of International Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan;1. Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte, MG, Brazil;2. Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Pós-Graduação em Ciências da Saúde, Infectologia e Medicina Tropical, Belo Horizonte, MG, Brazil;3. Universidade Federal de Minas Gerais (UFMG), Laboratório de Imunologia e Biologia Molecular (DIP-UFMG), Belo Horizonte, MG, Brazil;4. Universidade Federal de Minas Gerais (UFMG), Hospital das Clínicas, Belo Horizonte, MG, Brazil |
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Abstract: | BackgroundTransmitted drug resistance (TDR) reduces the efficacy of antiretroviral treatment and is a public health concern.ObjectivesTo gain insight in the epidemiology of TDR in Honduras by evaluating the amount of TDR in a representative sample of newly diagnosed individuals and by determining whether these are recent or established infections.Study designTwo hundred treatment-naïve, newly diagnosed HIV-positive individuals representing different population groups (general population, Garifunas ethnic group, female sex workers and men who have sex with men) and different geographic regions were enrolled during April 2004–April 2007. The HIV-1 pol gene was sequenced to identify drug-resistant mutations and TDR was scored as recommended by the WHO. Specimens were classified as recent or established infections using the BED assay.ResultsAmong 200 samples analyzed from Honduran patients the prevalence of TDR was 7% (95% CI: 3.9–11.5%), 5% for non-nucleoside reverse transcriptase inhibitors (NNRTIs), 3% for nucleoside reverse transcriptase inhibitors (NRTIs) and 0.5% for protease inhibitors (PIs). Testing of these samples with the BED assay revealed that 12% of the specimens were associated with recent infections. TDR was significantly more common in specimens with recent infection (21%) than established infection (5%) (p = 0.016).ConclusionsThe prevalence of TDR in Honduras was moderate (7%). The percentage of specimens who were recently infected was low (12%), suggesting that late HIV diagnosis is common. The TDR prevalence was higher in recent than in established infections, which may indicate that TDR is increasing over time. The higher prevalence of NNRTI and NRTI mutations as compared to PI mutations is probably due to a broader and longer use of these drugs in Honduras. |
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