Transmitted antiretroviral drug resistance in New York State, 2006-2008: results from a new surveillance system

• Published in: PloS one 2012-08, Vol.7 (8), p.e40533-e40533
• Main Authors: Readhead, Adam C, Gordon, Daniel E, Wang, Zhengyan, Anderson, Bridget J, Brousseau, Kathleen S, Kouznetsova, Maria A, Forgione, Lisa A, Smith, Lou C, Torian, Lucia V
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Analysis; Anti-Retroviral Agents - pharmacology; Anti-Retroviral Agents - therapeutic use; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Biology; Child; Confidence intervals; Demography; Diagnosis; Drug resistance; Drug Resistance, Viral - drug effects; Drug Resistance, Viral - genetics; Female; Genotype; Genotypes; Health aspects; HIV; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - transmission; HIV-1 - drug effects; HIV-1 - genetics; Human immunodeficiency virus; Humans; Infection; Laboratories; Male; Medical diagnosis; Medicine; Middle Aged; Mutation; Mutation - genetics; New York - epidemiology; Population Surveillance; Public health; Risk factors; Sexually transmitted diseases; STD; Surveillance; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0040533

HIV transmitted drug resistance (TDR) is a public health concern because it has the potential to compromise antiretroviral therapy (ART) at the population level. In New York State, high prevalence of TDR in a local cohort and a multiclass resistant case cluster led to the development and implementation of a statewide resistance surveillance system. We conducted a cross-sectional analysis of the 13,109 cases of HIV infection that were newly diagnosed and reported in New York State between 2006 and 2008, including 4,155 with HIV genotypes drawn within 3 months of initial diagnosis and electronically reported to the new resistance surveillance system. We assessed compliance with DHHS recommendations for genotypic resistance testing and estimated TDR among new HIV diagnoses. Of 13,109 new HIV diagnoses, 9,785 (75%) had laboratory evidence of utilization of HIV-related medical care, and 4,155 (43%) had a genotype performed within 3 months of initial diagnosis. Of these, 11.2% (95% confidence interval [CI], 10.2%-12.1%) had any evidence of TDR. The proportion with mutations associated with any antiretroviral agent in the NNRTI, NRTI or PI class was 6.3% (5.5%-7.0%), 4.3% (3.6%-4.9%) and 2.9% (2.4%-3.4%), respectively. Multiclass resistance was observed in