HIV Drug Resistance (HIVDR) in antiretroviral therapy-naive patients in Tanzania not eligible for WHO Threshold HIVDR survey is dramatically high

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dc.contributor.authorKasang, Christa
dc.contributor.authorKalluvya, Samuel
dc.contributor.authorMajinge, Charles
dc.contributor.authorStich, August
dc.contributor.authorBodem, Jochen
dc.contributor.authorKongola, Gilbert
dc.contributor.authorJacobs, Graeme Brendonen_ZA
dc.contributor.authorMlewa, Mathias
dc.contributor.authorMildner, Miriam
dc.contributor.authorHensel, Irina
dc.contributor.authorHorn, Anne
dc.contributor.authorPreiser, Wolfgang
dc.contributor.authorVan Zyl, Gert
dc.contributor.authorKlinker, Hartwig
dc.contributor.authorKoutsilieri, Eleni
dc.contributor.authorRethwilm, Axel
dc.contributor.authorScheller, Carsten
dc.contributor.authorWeissbrich, Benedikt
dc.contributor.editorKallas, Esper Georges
dc.date.accessioned2011-09-19T12:45:29Z
dc.date.available2011-09-19T12:45:29Z
dc.date.issued2011-08-19
dc.descriptionThe original publication is available at http://www.plosone.org/en_ZA
dc.descriptionDOI:10.1371/journal.pone.0023091en_ZA
dc.descriptionBibliography
dc.description.abstractBACKGROUND: The World Health Organization (WHO) has recommended guidelines for a HIV drug resistance (HIVDR) survey for resource-limited countries. Eligibility criteria for patients include age below 25 years in order to focus on the prevalence of transmitted HIVDR (tHIVDR) in newly-infected individuals. Most of the participating sites across Africa have so far reported tHIVDR prevalences of below 5%. In this study we investigated whether the rate of HIVDR in patients <25 years is representative for HIVDR in the rest of the therapy-naïve population. Methods and Findings HIVDR was determined in 88 sequentially enrolled ART-naïve patients from Mwanza, Tanzania (mean age 35.4 years). Twenty patients were aged <25 years and 68 patients were aged 25–63 years. The frequency of HIVDR in the study population was 14.8% (95%; CI 0.072–0.223) and independent of NVP-resistance induced by prevention of mother-to-child transmission programs. Patients >25 years had a significantly higher HIVDR frequency than younger patients (19.1%; 95% CI 0.095–0.28) versus 0%, P = 0.0344). In 2 out of the 16 patients with HIVDR we found traces of antiretrovirals (ARVs) in plasma. Conclusions ART-naïve patients aged over 25 years exhibited significantly higher HIVDR than younger patients. Detection of traces of ARVs in individuals with HIVDR suggests that besides transmission, undisclosed misuse of ARVs may constitute a significant factor in the generation of the observed high HIVDR rate. The current WHO tHIVDR survey that is solely focused on the transmission of HIVDR and that excludes patients over 25 years of age may therefore result in substantial underestimation of the prevalence of HIVDR in the therapy-naïve population. Similar studies should be performed also in other areas to test whether the so far reported optimistic picture of low HIVDR prevalence in young individuals is really representative for the rest of the ART-naïve HIV-infected population.en_ZA
dc.description.abstracten_ZA
dc.description.sponsorshipDeutsche Forschungsgemeinschaft (www.dfg.de; DFG IRTG 1522)en_ZA
dc.description.sponsorshipGerman Leprosy and Tuberculosis Relief Association (www.dahw.de)en_ZA
dc.description.sponsorshipEvangelisches Studienwerk e.V. Villigst (www.evstudienwerk.de)en_ZA
dc.description.sponsorshipDeutscher Akademischer Austauschdienst (www.daad.de)en_ZA
dc.description.sponsorshipBayerische Staatsregierung (www.bayern.de)en_ZA
dc.description.sponsorshipGesellschaft für AIDS-Forschung e.V. (Göttingen, no URL)en_ZA
dc.description.versionPublishers' Versionen_ZA
dc.format.extent11 p. : ill.
dc.identifier.citationKasang, C. et al 2011. HIV Drug Resistance (HIVDR) in antiretroviral therapy-naive patients in Tanzania not eligible for WHO Threshold HIVDR survey is dramatically high. PLoS ONE 6(8), e23091, doi:10.1371/journal.pone.0023091en_ZA
dc.identifier.issn1932-6203 (online)
dc.identifier.urihttp://hdl.handle.net/10019.1/16403
dc.language.isoen_ZAen_ZA
dc.publisherPublic Library of Science (PLoS)en_ZA
dc.rights.holderThe authors retain the copyrighten_ZA
dc.subjectHIVDRen_ZA
dc.subjectAntiretroviral agents -- Therapeutic useen_ZA
dc.subjectWHO Threshold HIVDR Surveyen_ZA
dc.subjectDrug resistance in HIV patients -- Tanzaniaen_ZA
dc.subjectScientific surveysen_ZA
dc.subjectHIV patients -- Antiretroviral therapy -- Tanzania -- Surveysen_za
dc.subjectHIV-positive persons -- Drug resistance -- Tanzaniaen_ZA
dc.subject.corpWorld Health Organizationen_ZA
dc.subject.corpUnited Nations Programme on AIDSen_ZA
dc.subject.corpWHO-UNAIDS HIV Vaccine Initiativeen_ZA
dc.titleHIV Drug Resistance (HIVDR) in antiretroviral therapy-naive patients in Tanzania not eligible for WHO Threshold HIVDR survey is dramatically highen_ZA
dc.typeArticleen_ZA
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