HIV drug resistance threshold survey using specimens from voluntary counselling and testing sites in Hanoi, Vietnam.
BACKGROUND
In countries where antiretroviral therapy has been available or is being rapidly expanded, the World Health Organization (WHO) recommends surveillance for transmitted HIV drug resistance (HIVDR) by threshold surveillance methods using specimens from antenatal clinics or voluntary counselling and testing (VCT) sites. The aim of this study was to implement the HIVDR threshold survey in VCT sites in Vietnam, where HIV prevalence is high. Estimating transmitted resistance in the infected population will enable the appropriateness of current antiretroviral drug regimens to be assessed and will inform plans for future HIVDR surveillance.


METHODS
Consecutive blood specimens were collected from 70 newly diagnosed HIV-positive clients 18-24 years of age at two sites in Hanoi, Vietnam. Informed consent and serum specimens were obtained from each eligible client, with serum frozen at -70 degrees C until shipping to Thailand for resistance testing using the TruGene system.


RESULTS
From February until August 2006, 559 clients were eligible to participate in this survey. Of the 535 clients (95.7%) who agreed to participate, 70 (13%) were HIV-positive and were included in the survey. Of the 70 specimens sent for genotyping, 52 consecutive samples were amplified, 49 of which could be genotyped. Only 1 of 49 genotyped specimens had mutations associated with drug resistance (L74V and Y181C) in the reverse transcriptase gene, indicating that the prevalence of transmitted HIVDR to all drugs and drug classes evaluated was <5%.


CONCLUSIONS
The prevalence of transmitted HIVDR was low in Hanoi as determined using threshold surveillance methods. The Ministry of Health plans to repeat this survey methodology in one more province and to confirm these findings by expanded HIVDR surveillance.
National institute for Hygiene and Epidemiology, Hanoi, Vietnam. nthiennihe@vnn.vn
Hien Tran
HT
Nguyen
Nguyen Bui
NB
Duc
Ritu
R
Shrivastava
Tram Hong
TH
Tran
Tuan Anh
TA
Nguyen
Pham Hang
PH
Thang
Janet M
JM
McNicholl
Wanna
W
Leelawiwat
Wannee
W
Chonwattana
Kassim
K
Sidibe
Masami
M
Fujita
Chau Minh T
CM
Luu
Reshma
R
Kakkar
Diane E
DE
Bennett
Jonathan
J
Kaplan
Lisa
L
Cosimi
Mitchell I
MI
Wolfe
D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D003376:Counseling; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission* / Q000821:virology; D016333:HIV Protease / Q000235:genetics; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000201:enzymology / Q000235:genetics*; D006801:Humans; D008297:Male; D025202:Molecular Diagnostic Techniques; D009154:Mutation; D009313:National Health Programs; D011159:Population Surveillance; D011247:Pregnancy; D011295:Prenatal Care; D015397:Program Evaluation; D016896:Treatment Outcome; D014744:Vietnam / Q000453:epidemiology; D014944:World Health Organization
D044966:Anti-Retroviral Agents; C514824:reverse transcriptase, Human immunodeficiency virus 1; D054303:HIV Reverse Transcriptase; D016333:HIV Protease; C514803:p16 protease, Human immunodeficiency virus 1