Diversity of HIV type 1 and drug resistance mutations among injecting drug users in Kenya.

Drug use in Kenya dates back to the precolonial period but research among drug users in relation to human immunodeficiency virus (HIV)-associated risk and intervention strategies has been low. To evaluate HIV-1 diversity and drug resistance among injecting drug users (IDUs), a cross-sectional study involving 58 patients was carried out in Mombasa between February and March 2010. HIV-1 RNA was extracted from plasma and polymerase chain reaction using specific primers for HIV-1 reverse transcriptase was done. Population sequencing was done and subtypes were determined phylogenetically. The prevalent HIV-1 subtypes were A1 (52/58), D (5/58), and C (2/58). The prevalence of drug resistance was 13.8% (8/58) with detection of nucleoside reverse transcriptase inhibitor (NRTI) mutations, T215F (n=5), K219Q (n=3), M184V (n=1), and nonnucleoside RTI mutation, K103N (n=1). Antiretroviral therapy (ART) and its monitoring among infected Kenyan IDUs is feasible. Policymakers and service providers in HIV prevention initiatives should improve service delivery so as to measure ART coverage among IDUs to prevent further transmission of drug-resistant variants.