Low Prevalence of Transmitted Drug Resistance of HIV-1 During 2008–2012 Antiretroviral Therapy Scaling up in Southern Vietnam

Abstract

There was no increase in TDR prevalence in Southern Vietnam during and after the 2008-2012 rapid scale up of ART.

An Alarmingly High Proportion of HIV-1 Isolates Carrying Mutations Corresponding to Resistance to Antiretroviral Drugs among HIV-Positive High-Risk Groups in Central Vietnam: a Substudy of the National Sentinel Survey

“…Considering this fact and the report from other parts of Vietnam (6.6 ) (17,18,24), our results on the DRM rate in the IDU population (47.4 ) and in the MSM population (33.3 ) are still alarmingly high.…”

“…The DRM rate in the ART naïve HIV-positive population ranges from 2.6 to 5.3 in countries such as China, India, Thailand, Hong Kong, Philippines, and Malaysia. Studies in Vietnam have shown an HIV drug resistance rate of around 3.5 to 8.2 (12,(17)(18)(19)(20). Higher DRM rates, 9.2 and 14.2 , were observed among ART-naïve MSM in Thailand and China, respectively (21,22).…”

“…Our results suggest that the high prevalence of drug resistance may be due to a higher proportion of IDUs in the HIV-positive population in Vietnam. During the 2008-2009 period, some studies showed that there were 6.2 and 5.4 of drug-resistant HIV isolates among HIV-infected patients in north and south Vietnam, respectively (17,18). The DRM rate in the ART naïve HIV-positive population ranges from 2.6 to 5.3 in countries such as China, India, Thailand, Hong Kong, Philippines, and Malaysia.…”

Different Effects of Nonnucleoside Reverse Transcriptase Inhibitor Resistance Mutations on Cytotoxic T Lymphocyte Recognition between HIV-1 Subtype B and Subtype A/E Infections

“…Drug treatment often increases the risk of subsequent transmission of drug resistance in new cases of an HIV infection. The Y181C mutation was also reported in treatment-naive individuals among different cohorts (see Table S1 in the supplemental material) at 2.3% (1/43), 1.1% (1/91), 0.6% (1/156), 3.0% (3/101), and 1.6% (2/129) of treatment-naive subtype C-infected individuals in Mozambique (42), in South India (43), in KwaZulu-Natal Provinces in South Africa (44), in Tanzania (45), and in China (46), respectively, and 0.43% of 1,389 treatment-naive individuals in southern Vietnam, where subtype A/E virus was the most prevalent subtype (47). The Y181C mutation or the Y181C/I mutation was detected in 0.4%, 0.3% (1/303), 0.2% (4/2,655), and 1.8% (6/336) of treatment-naive individuals in northern Poland (48), Brazil (49), Mexico (50), and Hondurans (51), respectively, where subtype B was the most prevalent.…”

Strength of recommendations in WHO guidelines using GRADE was associated with uptake in national policy

“…Four principle online resources were used to identify national guidelines: The USAID AIDSTAR-One National Treatment Database for HIV [7], AIDSspace Guideline Repository [8], the WHO Database of National HIV and TB guidelines 2005-2011 [9], and the UNAIDS Global Database of HIV/AIDS guidelines [10]. National guidelines had to fulfill the following criteria: published in English, low-or middle-income setting as determined by World Bank income grouping [11], and published between January 1, 2009 (when WHO first adopted the GRADE process), and December 31, 2013.…”