Camilla Muccini1,2, Suteeraporn Pinyakorn3,4, Sunee Sirivichayakul5, Eugene Kroon2,6, Carlo Sacdalan2,6, Trevor A Crowell3,4, Rapee Trichavaroj6,7, Jintanat Ananworanich8, Sandhya Vasan3,4, Nittaya Phanuphak2,6, Donn J Colby2,3,4,6. 1. Vita-Salute San Raffaele University, Milan, Italy. 2. SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand. 3. Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD. 4. U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD. 5. Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 6. Institute of HIV Research and Innovation, Bangkok, Thailand. 7. Department of Retrovirology, Armed Forces Research Institute of Medical Sciences, US Component, Bangkok, Thailand; and. 8. Department of Global Health, the University of Amsterdam, Amsterdam, the Netherlands.
Abstract
BACKGROUND: The greater availability of different antiretroviral therapy regimens in developing countries may influence the emergence of transmitted drug resistance (TDR). People with acute HIV infection (AHI) represent the best opportunity for real-time monitoring of TDR. This study assessed the TDR prevalence trends over time in a Thai cohort of predominantly men who have sex with men (MSM) with AHI. METHODS: At the time of RV254/SEARCH010 study (NCT00796146) enrollment and before starting ART, HIV genotyping was used to identify mutations in the reverse transcriptase and protease genes. Testing for TDR mutations was obtained by a validated in-house method with TRUGENE assay in a subset. Genotype sequences were analyzed using the Stanford University HIV Drug Resistance Database. RESULTS: Genotyping was performed for 573 participants with AHI. Their median age was 26 years (interquartile range 22-31), 97.4% were men, and 94.1% were MSM. Overall TDR prevalence was 7.0%, declining from 12.5% in 2009-2010 to 4.8% in 2017-2018. A declining resistance prevalence to nonnucleoside reverse transcriptase inhibitor emerged from 9.4% in 2009-2010 to 3.5% in 2017-2018 and to nucleoside reverse transcriptase inhibitor from 6.3% to 2.1%. Protease inhibitor resistance showed a decreased TDR level from 3.1% in 2009-2010 to 1.4% in 2017-2018. CONCLUSIONS: We report an encouraging declining trend in TDR prevalence in a Thai cohort of mainly MSM from 2009 to 2018; in 2017-2018, we observed a low TDR prevalence according to the World Health Organization definition.
BACKGROUND: The greater availability of different antiretroviral therapy regimens in developing countries may influence the emergence of transmitted drug resistance (TDR). People with acute HIV infection (AHI) represent the best opportunity for real-time monitoring of TDR. This study assessed the TDR prevalence trends over time in a Thai cohort of predominantly men who have sex with men (MSM) with AHI. METHODS: At the time of RV254/SEARCH010 study (NCT00796146) enrollment and before starting ART, HIV genotyping was used to identify mutations in the reverse transcriptase and protease genes. Testing for TDR mutations was obtained by a validated in-house method with TRUGENE assay in a subset. Genotype sequences were analyzed using the Stanford University HIV Drug Resistance Database. RESULTS: Genotyping was performed for 573 participants with AHI. Their median age was 26 years (interquartile range 22-31), 97.4% were men, and 94.1% were MSM. Overall TDR prevalence was 7.0%, declining from 12.5% in 2009-2010 to 4.8% in 2017-2018. A declining resistance prevalence to nonnucleoside reverse transcriptase inhibitor emerged from 9.4% in 2009-2010 to 3.5% in 2017-2018 and to nucleoside reverse transcriptase inhibitor from 6.3% to 2.1%. Protease inhibitor resistance showed a decreased TDR level from 3.1% in 2009-2010 to 1.4% in 2017-2018. CONCLUSIONS: We report an encouraging declining trend in TDR prevalence in a Thai cohort of mainly MSM from 2009 to 2018; in 2017-2018, we observed a low TDR prevalence according to the World Health Organization definition.
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Authors: Miguel A Arroyo; Nittaya Phanuphak; Somporn Krasaesub; Sunee Sirivichayakul; Vatcharain Assawadarachai; Kultida Poltavee; Tippawan Pankam; Jintanat Ananworanich; Robert Paris; Sodsai Tovanabutra; Gustavo H Kijak; Francine E McCutchan; Praphan Phanuphak; Jerome H Kim; Mark de Souza Journal: AIDS Res Hum Retroviruses Date: 2010-01 Impact factor: 2.205