Stable level of HIV transmitted drug resistance in Estonia despite significant scale-up of antiretroviral therapy

Soodla, Pilleriin; Huik, Kristi; Pauskar, Merit; Cuypers, Lize; Laethem, Kristel Van; Rajasaar, Heli; Kallas, Eveli; Lepa, Helen; Velts-Lindh, Anna; Jõgeda, Ene-Ly; Lutsar, Irja; Avi, Radko

doi:10.1016/j.meegid.2019.05.019

Cited by 1 publication

(1 citation statement)

References 37 publications

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“…The most common TDR mutation observed in (P5) this study was K103N in the NNRTI resistance class. This finding is consistent with those of other studies conducted in Vietnam (3,12) and similar to findings from other low-and middle-income countries (20)(21)(22)(23)(24)(25). K103N and Y181C/F are drug resistance mutations that can develop in response to treatment with NNRTIs, such as nevirapine or efavirenz.…”

Section: Discussionsupporting

confidence: 92%

Prevalence of transmitted drug resistance and phylogenetic analysis of HIV-1 among antiretroviral therapy-naïve patients in Northern Vietnam from 2019 to 2022

Tran,

Hayashida,

Dang

et al. 2024

GHM

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Since the rapid expansion of antiretroviral therapy (ART) for HIV, transmitted drug resistance (TDR) has become a major concern in Vietnam. HIV services there are transitioning to be covered by social insurance. Access to pre-exposure prophylaxis (PrEP) is being expanded to tackle the growing HIV epidemic among men who have sex with men. Therefore, a cross-sectional study was conducted at 10 ART facilities in Northern Vietnam from 9 th December 2019 to 9 th June 2022 to investigate the prevalence and pattern of TDR among ART-naïve people living with HIV (PLWH). TDR mutations were defined according to the World Health Organization 2009 List of Mutations for Surveillance of Transmitted Drug Resistant HIV Strains. Mutation transmission dynamics and TDR clusters were investigated via phylogenetic analysis. We enrolled 391 ART-naïve PLWH. The overall TDR prevalence was 4.6%, with an annual prevalence of 6.0% in 2019/2020, 4.8% in 2021, and 1.3% in 2022. TDR mutations to non-nucleoside reverse transcriptase inhibitors (2.8%), including K103N were the most common. Less commonly, the protease inhibitor-associated mutation M46I and mutations to nucleoside reverse transcriptase inhibitors, including M184V/ I, were observed. CRF01_AE was the most common subtype (77.0%). CRF07_BC (14.3%), which had been rare in Vietnam, was also observed. No genetic association was observed between HIV-1 sequences with TDR mutations. In conclusion, the overall prevalence of TDR was stably low in this region. The phylogenetic tree suggests that TDR clusters have not formed. Continuous monitoring of HIV TDR and strains is crucial to maintaining ART and PrEP efficacy.

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