High prevalence of pre-treatment HIV drug resistance in Papua New Guinea: findings from the first nationally representative pre-treatment HIV drug resistance study

Determining the prevalence of pre-treatment HIV drug resistance (PDR) is important to assess the effectiveness of first-line therapies. To determine PDR prevalence in Papua New Guinea (PNG), we conducted a nationally representative survey. We used a two-stage cluster sampling method to recruit HIV t...

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Bibliographic Details
Published in:BMC infectious diseases 2022-03, Vol.22 (1), p.266-266, Article 266
Main Authors: Gare, Janet, Toto, Ben, Pokeya, Percy, Le, Linh-Vi, Dala, Nick, Lote, Namarola, John, Bangan, Yamba, Abel, Soli, Kevin, DeVos, Joshua, Paulin, Heather, Wagar, Nick, Zheng, Du-Ping, Nishijima, Takeshi, Boas, Peniel, Kelly-Hanku, Angela, Gurung, Anup
Format: Article
Language:English
Subjects:
Anti-HIV agents
Anti-HIV Agents - pharmacology
Anti-HIV Agents - therapeutic use
Antiretroviral therapy
Antiviral agents
Distribution
Drug resistance
Drug Resistance, Viral
Genotype
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV-1 - genetics
Human immunodeficiency virus
Humans
Papua New Guinea
Papua New Guinea - epidemiology
Patient outcomes
Pre-treatment drug resistance
Prevalence
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Summary:Determining the prevalence of pre-treatment HIV drug resistance (PDR) is important to assess the effectiveness of first-line therapies. To determine PDR prevalence in Papua New Guinea (PNG), we conducted a nationally representative survey. We used a two-stage cluster sampling method to recruit HIV treatment initiators with and without prior exposure to antiretroviral therapies (ART) in selected clinics. Dried blood spots were collected and tested for PDR. A total of 315 sequences were available for analysis. The overall PDR prevalence rate was 18.4% (95% CI 13.8-24.3%). The prevalence of PDR to non-nucleoside analog reverse-transcriptase inhibitors (NNRTIs) was 17.8% (95% CI 13.6-23.0%) and of PDR to nucleoside reverse transcriptase inhibitors (NRTIs) was 6.3% (95% CI 1.6-17.1%). The PDR prevalence rate among people reinitiating ART was 42.4% (95% CI 29.1-56.4%). PNG has a high PDR prevalence rate, especially to NNRTI-based first-line therapies. Our findings suggest that removing NNRTIs as part of first-line treatment is warranted and will lead to improving viral suppression rates in PNG.
ISSN:1471-2334
1471-2334
DOI:10.1186/s12879-022-07264-y