High Levels of Transmitted HIV Drug Resistance in a Study in Papua New Guinea
High Levels of Transmitted HIV Drug Resistance in a Study in Papua New Guinea
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DOI：
10.1371/journal.pone.0170265
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发表时间：
2017-02-01
期刊：
影响因子：
3.7
通讯作者：
Jordan, Michael R.
中科院分区：
文献类型：
--
作者：
Lavu, Evelyn;Kave, Ellan;Jordan, Michael R.
巴布亚新几内亚是一个拥有730万人口的太平洋岛国，估计艾滋病毒感染率为0.8%。ART的启动和监测由临床分期和CD 4细胞计数（如可用）指导。鲜为人知的是，在最近感染的个人在巴布亚新Guinea.MethodsSurveillance传播的艾滋病毒耐药性的水平在最近感染艾滋病毒和年龄小于30岁的123个人在莫尔兹比港（n = 62）和哈根山（n = 61）在2013年5月至2014年4月期间实施了传播的艾滋病毒耐药性。使用干血斑进行HIV耐药性测试。结果非核苷类逆转录酶抑制剂传播的HIV耐药率为16.1%（12/10），其中非核苷类逆转录酶抑制剂传播的HIV耐药率为16.1%（12/10），非核苷类逆转录酶抑制剂传播的HIV耐药率为16.1%（12/10），非核苷类逆转录酶抑制剂传播的HIV耐药率为16.1%（12/10）Port Moresby和Mount哈根分别为8.2%（95% CI 8.8%-27.4%）和8.2%（95% CI 3.2%-18.2%）。Moresby港和Mount哈根的核苷类逆转录酶抑制剂传播的HIV耐药率分别为3.2%（95%CI 0.2%~ 11.7%）和3.3%（95%CI 0.2%~ 11.8%）。没有蛋白酶抑制剂传播的HIV耐药性observed.ConclusionsThe水平的非核苷类逆转录酶抑制剂的耐药性在抗逆转录病毒药物的个人最近感染了HIV在莫尔兹比港是全球最高的报道之一。在性活跃的年轻人群中，这种令人震惊的艾滋病毒耐药性水平可能会限制非核苷类逆转录酶抑制剂作为巴布亚新几内亚一线抗逆转录病毒治疗组成部分的持续有效使用。为支持选择国家推荐的一线抗逆转录病毒疗法，应紧急对巴布亚新几内亚抗逆转录病毒疗法启动者中的艾滋病毒耐药性进行有代表性的监测。
IntroductionPapua New Guinea is a Pacific Island nation of 7.3 million people with an estimated HIV prevalence of 0.8%. ART initiation and monitoring are guided by clinical staging and CD4 cell counts, when available. Little is known about levels of transmitted HIV drug resistance in recently infected individuals in Papua New Guinea.MethodsSurveillance of transmitted HIV drug resistance in a total of 123 individuals recently infected with HIV and aged less than 30 years was implemented in Port Moresby (n = 62) and Mount Hagen (n = 61) during the period May 2013-April 2014. HIV drug resistance testing was performed using dried blood spots. Transmitted HIV drug resistance was defined by the presence of one or more drug resistance mutations as defined by the World Health Organization surveillance drug resistance mutations list.ResultsThe prevalence of non-nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 16.1% (95% CI 8.8%-27.4%) and 8.2% (95% CI 3.2%-18.2%) in Port Moresby and Mount Hagen, respectively. The prevalence of nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 3.2% (95% CI 0.2%-11.7%) and 3.3% (95% CI 0.2%-11.8%) in Port Moresby and Mount Hagen, respectively. No protease inhibitor transmitted HIV drug resistance was observed.ConclusionsThe level of non-nucleoside reverse transcriptase inhibitor drug resistance in antiretroviral drug naive individuals recently infected with HIV in Port Moresby is amongst the highest reported globally. This alarming level of transmitted HIV drug resistance in a young sexually active population threatens to limit the on-going effective use of NNRTIs as a component of first-line ART in Papua New Guinea. To support the choice of nationally recommended first-line antiretroviral therapy, representative surveillance of HIV drug resistance among antiretroviral therapy initiators in Papua New Guinea should be urgently implemented.