Low Prevalence of Primary HIV Resistance in Western Massachusetts

Abstract

Most studies of primary antiretroviral (ARV) resistance have been conducted in large metropolitan areas with reported rates of 8% to 25%. We collected data on 99 HIV-1-infected antiretroviral-naive patients from several sites in Springfield, MA, who underwent genotypic resistance assay between 2004 and 2008. Only major resistance mutations per International AIDS Society-USA (IAS-USA) drug resistance mutations list were considered. The prevalence of resistance was 5% (5 of 99). Three patients had one nonnucleoside reverse transcriptase inhibitor (NNRTI) mutation: 103N, 103N, and 190A, 1 patient had a protease inhibitor (PI) mutation: 90M; and 1 patient had 3-class resistance with NNRTI: 181C, 190A, PI: 90M, and nucleoside analogue reverse transcriptase inhibitor (NRTI): 41L, 210W. Mean time from HIV diagnosis to resistance testing was shorter in patients with resistance versus those without: 9 (range 0.3-42 months) versus 27 (range 0.1-418 months), P ¼ .11. There was a trend to lower mean CD4 count in those with resistance, 170 versus 318 cells/mm 3 , P ¼ .06. No differences were noted in gender, age, HIV risk category, or HIV RNA level. The low prevalence of primary resistance may be explained by differences in demographic and risk factors or may reflect the time from infection to resistance testing. Our findings emphasize the importance of continued resistance surveillance.

Prevalence of Drug Resistance and Associated Mutations in a Population of HIV-1+Puerto Ricans: 2006–2010

“…Several studies from developed countries have not identified gender as a predictor for primary drug resistance [52–54], while others report that mutation prevalence is higher in males [46]. In a recent study, females showed 2-fold odds of having virological failure compared with males at one year after genotype resistance testing, independent of race or a history of optimal treatment [55].…”