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Moderate levels of pre-treatment HIV-1 antiretroviral drug resistance detected in the first South African national survey

dc.contributor.authorSteegen, Kimen_ZA
dc.contributor.authorCarmona, Sergioen_ZA
dc.contributor.authorBronze, Michelleen_ZA
dc.contributor.authorPapathanasopoulos, Maria A.en_ZA
dc.contributor.authorVan Zyl, Gerten_ZA
dc.contributor.authorGoedhals, Dominiqueen_ZA
dc.contributor.authorMacLeod, Williamen_ZA
dc.contributor.authorSanne, Ianen_ZA
dc.contributor.authorStevens, Wendy S.en_ZA
dc.date.accessioned2017-10-11T13:42:08Z
dc.date.available2017-10-11T13:42:08Z
dc.date.issued2016
dc.identifier.citationSteegen, K. et al. 2016. Moderate levels of pre-treatment HIV-1 antiretroviral drug resistance detected in the first South African national survey. PLoS ONE, 11(12): e0166305, doi:10.1371/journal.pone.0166305en_ZA
dc.identifier.issn1932-6203 (online)
dc.identifier.otherdoi:10.1371/journal.pone.0166305
dc.identifier.urihttp://hdl.handle.net/10019.1/102310
dc.descriptionCITATION: Steegen, K. et al. 2016. Moderate levels of pre-treatment HIV-1 antiretroviral drug resistance detected in the first South African national survey. PLoS ONE, 11(12): e0166305, doi:10.1371/journal.pone.0166305.en_ZA
dc.descriptionThe original publication is available at http://journals.plos.org/plosoneen_ZA
dc.description.abstractBackground: In order to assess the level of transmitted and/or pre-treatment antiretroviral drug resistance to HIV-1, the World Health Organization (WHO) recommends that regular surveys are conducted. This study’s objective was to assess the frequency of HIV-1 antiretroviral drug resistance in patients initiating antiretroviral treatment (ART) in the public sector throughout South Africa. Methods: A prospective cross-sectional survey was conducted using probability proportional to size sampling. This method ensured that samples from each province were proportionally collected, based on the number of patients receiving ART in each region. Samples were collected between March 2013 and October 2014. Pol sequences were obtained using RT-PCR and Sanger sequencing and submitted to the Stanford Calibrated Population Resistance tool v6.0. Results: A total of 277 sequences were available for analysis. Most participants were female (58.8%) and the median age was 34 years (IQR: 29–42). The median baseline CD4-count was 149 cells/mm3 (IQR: 62–249) and, based on self-reporting, participants had been diagnosed as HIV-positive approximately 44 days prior to sample collection (IQR: 23–179). Subtyping revealed that 98.2% were infected with HIV-1 subtype C. Overall, 25 out of 277 patients presented with ≥1 surveillance drug resistance mutation (SDRM, 9.0%, 95% CI: 6.1–13.0%). Non-nucleoside reverse transcriptase inhibitor (NNRTI) mutations were the most numerous mutations detected (n = 23). Only two patients presented with a protease inhibitor (PI) mutation. In four patients ≥4 SDRMs were detected, which might indicate that these patients were not truly ART-naïve or were infected with a multi-resistant virus. Conclusions: These results show that the level of antiretroviral drug resistance in ART-naïve South Africans has reached moderate levels, as per the WHO classification. Therefore, regular surveys of pre-treatment drug resistance levels in all regions of South Africa is highly recommended to monitor the changing levels of pre-treatment antiretroviral drug resistance.en_ZA
dc.description.urihttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0166305en_ZA
dc.format.extent12 pagesen_ZA
dc.language.isoen_ZAen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.subjectHIV-1 antiretroviral drugen_ZA
dc.subjectAntiretroviral agentsen_ZA
dc.subjectHIV infections -- Preventionen_ZA
dc.subjectDrug resistanceen_ZA
dc.titleModerate levels of pre-treatment HIV-1 antiretroviral drug resistance detected in the first South African national surveyen_ZA
dc.typeArticleen_ZA
dc.description.versionPublisher's versionen_ZA
dc.rights.holderAuthors retain copyrighten_ZA


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