Chimukangara, B;
Kharsany, AB;
Lessells, RJ;
Naidoo, K;
Rhee, S-Y;
Manasa, J;
Gräf, T;
... de Oliveira, T; + view all
(2019)
Moderate-to-High Levels of Pretreatment HIV Drug Resistance in KwaZulu-Natal Province, South Africa.
AIDS Research and Human Retroviruses
, 35
(2)
pp. 129-138.
10.1089/AID.2018.0202.
Preview |
Text
Pillay_Moderate to high levels of pre-treatment HIV drug resistance in KwaZulu-Natal Province, South Africa_AAM.pdf - Accepted Version Download (620kB) | Preview |
Abstract
INTRODUCTION: There is evidence of increasing levels of pre-treatment HIV drug resistance (PDR) in Southern Africa. We used data from two large population-based HIV surveillance studies to estimate prevalence of PDR in KwaZulu-Natal, the province with the highest HIV prevalence in South Africa. METHODS: Sanger sequencing was performed on samples obtained from a longitudinal HIV surveillance programme (study A, 2013-2014) and the HIV Incidence Provincial Surveillance System (study B, 2014-2015). Sequences were included for adult HIV positive participants (age ≥15 years for study A, age 15-49 years for study B) with no documented prior exposure to ART. Overall and drug class-specific PDR was estimated using the World Health Organization 2009 surveillance drug resistance mutation (SDRM) list and phylogenetic analysis was performed to establish evidence of drug resistance transmission linkage. RESULTS: One thousand eight hundred and forty-five (1845) sequences were analysed (611 study A; 1234 study B). An overall PDR prevalence of 9.2% (95% confidence interval (CI): 7.0-11.7) was observed for study A and 11.0% (95% CI 8.9-13.2) for study B. In study B, the prevalence of non-nucleoside reverse-transcriptase inhibitor (NNRTI) PDR exceeded 10% for sequences collected in 2014 (10.2%, 95% CI 7.5-12.9). The most prevalent SDRMs were K103NS (7.5%), M184VI (2.4%) and V106AM (1.4%). There was no evidence of large transmission chains of drug-resistant virus. CONCLUSION: High level NNRTI-PDR (>10%) suggests a need to modify the standard first-line ART regimen and to focus attention on improving the quality of HIV prevention, treatment and care.
| Type: | Article |
|---|---|
| Title: | Moderate-to-High Levels of Pretreatment HIV Drug Resistance in KwaZulu-Natal Province, South Africa |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1089/AID.2018.0202 |
| Publisher version: | https://doi.org/10.1089/AID.2018.0202 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | HIV, pre‐treatment drug resistance, antiretroviral therapy, surveillance, molecular epidemiology, South Africa |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10062405 |
Archive Staff Only
 |
View Item |
