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Research Article Volume 6 Issue 1
National Survey of Pretreatment HIV-Drug Resistance in Thai HIV-1-Infected Adults
Cheewanan Lertpiriyasuwat, Surapol Kohreanudom, Naparat Pattaraprayoon, Siriphan Saeng aroon
Department of Disease Control, Institute of Research, Knowledge Management and Standards for Disease Control, Ministry of Public Health, Thailand
Department of Disease Control, Bureau of AIDS, TB and STIs, Ministry of Public Health, Thailand
Department of Medical Sciences, National Institute of Health, Ministry of Public Health, Thailand
Received: December 13, 2017 | Published: February 8, 2018
Citation: Lertpiriyasuwat C, Kohreanudom S, Pattaraprayoon N, Saeng-aroon S (2018) National Survey of Pretreatment HIV-Drug Resistance in Thai HIV-1-Infected Adults. J Hum Virol Retrovirol 6(1): 00190. DOI: 10.15406/jhvrv.2018.06.00190
Abstract
1.1. Background: WHO recommended a method to estimate nationally representative pretreatment HIV drug resistance (PDR) prevalence for providing evidence in selection of first-line antiretroviral treatment regimens. This study aimed to assess PDR prevalence in Thai HIV-1 infected adults.
1.2. Methods: We conducted a cross-sectional survey among patients aged18 years and above who were antiretroviral drug (ARV)-naïve or prior-exposed to ARVs and interrupted for more than three months. Twenty hospitals were sampled using probability proportional to size of patients initiating ART. Then a consecutive enrolment of eligible patients was done during August 2016-February 2017. Plasma specimens were collected for genotyping.
1.3. Results: Of 327 patients with genotypic results, most of them were men (48.6%), naive (84.4%) and infected with HIV-1 subtype CRF01_AE (90.7%). Median CD4 count was 160cells/mm3 and median viral load was 83,696 copies/ml. Overall PDR prevalence was 8.2% (95% CI 4.5-14.7). The prevalence was 0.2% (95% CI 0.1-0.3) for any nucleoside reverse-transcriptase inhibitors (NRTIs), 8.1% (95% CI 4.3-14.5) for any non-NRTIs (NNRTIs), 1.2% (95% CI 0.2-7.1) for any protease inhibitors (PIs), 0.1% (95% CI 0.0-0.2) for both NRTIs and NNRTIs, and 1.1% (95% CI 0.2-7.5) for both PIs and NNRTIs. The most common surveillance drug resistance mutations were Y181C (2.3%), followed by K103N (2.0%) and G190A (1.1%), respectively.
1.4. Conclusion: NNRTIs resistance prevalence was less than 10% which was a WHO recommendation’s cut-off point for changing the first-line regimen. However, PDR surveillance should be conducted every three year and PDR prevention interventions should be implemented.
Keywords: Survey, Pretreatment HIV drug resistance, HIV-1, Thai, Antiretroviral, Non-nucleoside, Reverse-transcriptase, Inhibitor, Monitoring, Disease, Adults, Cross-sectional, Prophylaxis, Genotyping, Mutation
©2018 Lertpiriyasuwat, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.