Prevalence of pretreatment HIV drug resistance in Mwanza, Tanzania
| Autor: | Christa Kasang, Jan Markus Brauner, Karina Plugaru, Johanna Englert, Benson R. Kidenya, Carolina Seemann, Ladius Rudovick, Carsten Scheller, Samuel E. Kalluvya |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) medicine.medical_specialty Genotype Cross-sectional study Mutation Missense Human immunodeficiency virus (HIV) HIV Infections Drug resistance medicine.disease_cause Tanzania Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine Drug Resistance Viral Prevalence medicine Humans Pharmacology (medical) ddc:610 030212 general & internal medicine Young adult Aged Pharmacology biology Transmission (medicine) business.industry Public health HIV Sequence Analysis DNA Middle Aged biology.organism_classification Cross-Sectional Studies 030104 developmental biology Infectious Diseases pol Gene Products Human Immunodeficiency Virus Female business HIV drug resistance |
| Zdroj: | Journal of Antimicrobial Chemotherapy. |
| ISSN: | 1460-2091 0305-7453 |
| DOI: | 10.1093/jac/dky332 |
| Popis: | Background: In a 2008-10 study, we found a pretreatment HIV drug resistance (PDR) prevalence of 18.2% in patients at Bugando Medical Centre (BMC) in Mwanza, Tanzania. Objectives: To determine the prevalence of PDR and transmitted HIV drug resistance (TDR) in patients visiting the BMC from 2013 to 2015. Methods: Adult outpatients were sequentially enrolled into two groups, separated by whether they were initiating ART. Previous exposure to antiretroviral drugs, except for prevention of mother-to-child transmission, was an exclusion criterion. HIV pol sequences were analysed according to WHO guidelines for surveillance of PDR and TDR. Results: Two hundred and thirty-five sequences were analysed (138 ART initiators, 97 non-initiators). The prevalence of PDR was 4.7% (95% CI 2.6%-8.2%) overall, 3.1% (95% CI 1.1%-8.7%) for non-initiators and 5.8% (95% CI 3.0%-11.0%) for ART initiators. PDR to NNRTIs and nucleoside or nucelotide reverse transcriptase inhibitors was found in 3.0% (95% CI 1.5%-6.0%) and 1.7% (95% CI 0.7%-4.3%) of patients, respectively. Resistance to PIs was not observed. The prevalence of TDR was 6.0% (95% CI 3.6%-9.8%). Conclusions: Prevalence of PDR significantly decreased compared with 2008-10 and was below the WHO-defined threshold for triggering a public health response. National and systematic surveillance is needed to inform Tanzania's public health strategy. |
| Databáze: | OpenAIRE |
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