High prevalence of pre-treatment HIV drug resistance in Papua New Guinea: findings from the first nationally representative pre-treatment HIV drug resistance study.

Autor: Gare J; Sexual and Reproductive Health Unit, PNG Institute of Medical Research, Corner of Leigh Vial & Homate St, Goroka, Eastern Highlands Province, 441, Papua New Guinea. janet.gare@pngimr.org.pg., Toto B; Sexual and Reproductive Health Unit, PNG Institute of Medical Research, Corner of Leigh Vial & Homate St, Goroka, Eastern Highlands Province, 441, Papua New Guinea., Pokeya P; United States Centres for Disease Control and Prevention Country Office of Papua New Guinea, Port Moresby, National Capital District, Papua New Guinea., Le LV; HIV, Hepatitis and STI Unit, Division of Communicable Disease, World Health Organization Regional Office of the Western Pacific, Manila, Philippines., Dala N; Director's Office, National AIDS Council Secretariat, Port Moresby, National Capital District, Papua New Guinea., Lote N; World Health Organization Country Office of Papua New Guinea, Port Moresby, National Capital District, Papua New Guinea., John B; World Health Organization Country Office of Papua New Guinea, Port Moresby, National Capital District, Papua New Guinea., Yamba A; United States Centres for Disease Control and Prevention Country Office of Papua New Guinea, Port Moresby, National Capital District, Papua New Guinea., Soli K; United States Centres for Disease Control and Prevention Country Office of Papua New Guinea, Port Moresby, National Capital District, Papua New Guinea., DeVos J; Division of Global HIV and TB, International Lab Branch, United States Centers for Disease Control and Prevention, Atlanta, GA, USA., Paulin H; Division of Global HIV and TB, HIV Care and Treatment Branch, United States Centers for Disease Control and Prevention, Atlanta, GA, USA., Wagar N; Division of Global HIV and TB, International Lab Branch, United States Centers for Disease Control and Prevention, Atlanta, GA, USA., Zheng DP; Division of Global HIV and TB, International Lab Branch, United States Centers for Disease Control and Prevention, Atlanta, GA, USA., Nishijima T; National Center for Global Health and Medicine, Tokyo, Japan., Boas P; National HIV Program Division, National Department of Health, Port Moresby, National Capital District, Papua New Guinea., Kelly-Hanku A; Sexual and Reproductive Health Unit, PNG Institute of Medical Research, Corner of Leigh Vial & Homate St, Goroka, Eastern Highlands Province, 441, Papua New Guinea.; Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, NSW, Australia., Gurung A; World Health Organization Country Office of Papua New Guinea, Port Moresby, National Capital District, Papua New Guinea.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2022 Mar 19; Vol. 22 (1), pp. 266. Date of Electronic Publication: 2022 Mar 19.
DOI: 10.1186/s12879-022-07264-y
Abstrakt: Background: Determining the prevalence of pre-treatment HIV drug resistance (PDR) is important to assess the effectiveness of first-line therapies. To determine PDR prevalence in Papua New Guinea (PNG), we conducted a nationally representative survey.
Methods: We used a two-stage cluster sampling method to recruit HIV treatment initiators with and without prior exposure to antiretroviral therapies (ART) in selected clinics. Dried blood spots were collected and tested for PDR.
Results: A total of 315 sequences were available for analysis. The overall PDR prevalence rate was 18.4% (95% CI 13.8-24.3%). The prevalence of PDR to non-nucleoside analog reverse-transcriptase inhibitors (NNRTIs) was 17.8% (95% CI 13.6-23.0%) and of PDR to nucleoside reverse transcriptase inhibitors (NRTIs) was 6.3% (95% CI 1.6-17.1%). The PDR prevalence rate among people reinitiating ART was 42.4% (95% CI 29.1-56.4%).
Conclusions: PNG has a high PDR prevalence rate, especially to NNRTI-based first-line therapies. Our findings suggest that removing NNRTIs as part of first-line treatment is warranted and will lead to improving viral suppression rates in PNG.
(© 2022. The Author(s).)
Databáze: MEDLINE
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