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

BMC Infectious Diseases

Nick Dala¹  Heather Paulin²  Joshua DeVos³  Nick Wagar³  Du-Ping Zheng³  Linh-Vi Le⁴  Takeshi Nishijima⁵  Peniel Boas⁶  Ben Toto⁷  Janet Gare⁷  Angela Kelly-Hanku⁷  Kevin Soli⁸  Abel Yamba⁸  Percy Pokeya⁸  Anup Gurung⁹  Namarola Lote⁹  Bangan John⁹ 

[1] Director’s Office, National AIDS Council Secretariat;Division of Global HIV and TB, HIV Care and Treatment Branch, United States Centers for Disease Control and Prevention;Division of Global HIV and TB, International Lab Branch, United States Centers for Disease Control and Prevention;HIV, Hepatitis and STI Unit, Division of Communicable Disease, World Health Organization Regional Office of the Western Pacific;National Center for Global Health and Medicine;National HIV Program Division, National Department of Health;Sexual and Reproductive Health Unit, PNG Institute of Medical Research;United States Centres for Disease Control and Prevention Country Office of Papua New Guinea;World Health Organization Country Office of Papua New Guinea;

关键词: Human immunodeficiency virus;    Pre-treatment drug resistance;    Antiretroviral therapy;    Papua New Guinea;   

DOI  :  10.1186/s12879-022-07264-y

来源: DOAJ

【 摘 要 】

Abstract 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.

【 授权许可】

Unknown