|
Drug-resistance and BED assay testing in newly diagnosed HIV-1 individuals in Honduras to determine transmitted drug resistance in recent or established infections
W. Murillo1,2,3, I. L. de Rivera1, S. Morales4, T. Dobbs5, B.S. Parekh5, J. Albert2,3
1Universidad Nacional Autónoma de Honduras, UNAH, Dpto. de Microbiología, Tegucigalpa, Honduras, 2Swedish Institute for Infectious Disease Control (SMI), Department of Virology, Stockholm, Sweden, 3Karolinska Institute (KI), Microbiology Department, Stockholm, Sweden, 4Centers for Disease Control and Prevention (CDC), The Global AIDS Program for Central America (GAP), Ciudad Guatemala, Guatemala, 5Center for Disease Control and Prevention (CDC), Division of AIDS, STD, TB Laboratory Research and Division of HIV/AIDS Prevention, Atlanta, United States
Background: Transmitted drug-resistance (TDR) reduces the efficacy of initial antiretroviral treatment (ART) and has become a public health concern in countries where ART programs have been introduced. The objective of this study was to estimate TDR among newly diagnosed individuals from different population groups in Honduras and to use BED assay to determine recent or established infections in order to more accurately define TDR.
Methods: Drug-naïve newly diagnosed individuals were enrolled in the study during April 2004-April 2007; including 8 female sex workers (FSW), 28 men who had sex with men (MSM), 29 Garifunas (Black Caribbean Afro-descendents) and 131 from general population. HIV-1 pol gene sequences were generated to identify drug-resistance mutations. Resistance was scored according December 2008 version IAS-USA list. Infections were classified as recent or established according to the BED assay.
Results: 196 samples were analyzed; 24 (12%) were classified as recent infected and 172 (88%) as established infections. The overall TDR prevalence was 6%. 16.6% of those with recent infection and 4.6% with established infections presented drug-resistance to at least one class of antiretroviral drugs. BED-HIV incidence was 2.7% in MSM, 1.1% in Garifunas and 0% in FSW. TDR was found in 37.5% (3/8) FSW, 10.3% (3/29) in Garifunas, 4.5% (6/131) in general population and no TDR was found in MSM. All TDR cases displayed drug-resistance mutations in the reverse transcriptase gene (RT) only. None PI mutations were found.
Conclusions: The overall TDR prevalence was moderate (6%), but higher among FSW and Garifunas. BED-HIV incidence was low among Garifunas and FSW indicating that they have established infections with higher frequency of drug resistance viruses, BED-HIV incidence is high in MSM (2.7%). The fact that we observed NRTI and NNRTI, but not PI, mutations may be due to a broader and longer use these drugs in the country.
|