title: Transmitted drug resistance and type of infection in newly diagnosed HIV-1 individuals in Honduras.
abstract: BACKGROUND
  Transmitted drug resistance (TDR) reduces the efficacy of antiretroviral treatment and is a public health concern.
  
  
  OBJECTIVE
  To gain insight in the epidemiology of TDR in Honduras by evaluating the amount of TDR in a representative sample of newly diagnosed individuals and by determining whether these are recent or established infections.
  
  
  METHODS
  Two hundred treatment-naïve, newly diagnosed HIV-positive individuals representing different population groups (general population, Garifunas ethnic group, female sex workers and men who have sex with men) and different geographic regions were enrolled during April 2004-April 2007. The HIV-1 pol gene was sequenced to identify drug-resistant mutations and TDR was scored as recommended by the WHO. Specimens were classified as recent or established infections using the BED assay.
  
  
  RESULTS
  Among 200 samples analyzed from Honduran patients the prevalence of TDR was 7% (95% CI: 3.9-11.5%), 5% for non-nucleoside reverse transcriptase inhibitors (NNRTIs), 3% for nucleoside reverse transcriptase inhibitors (NRTIs) and 0.5% for protease inhibitors (PIs). Testing of these samples with the BED assay revealed that 12% of the specimens were associated with recent infections. TDR was significantly more common in specimens with recent infection (21%) than established infection (5%) (p=0.016).
  
  
  CONCLUSIONS
  The prevalence of TDR in Honduras was moderate (7%). The percentage of specimens who were recently infected was low (12%), suggesting that late HIV diagnosis is common. The TDR prevalence was higher in recent than in established infections, which may indicate that TDR is increasing over time. The higher prevalence of NNRTI and NRTI mutations as compared to PI mutations is probably due to a broader and longer use of these drugs in Honduras.
authors.affiliation: Microbiology Department, National Autonomous University of Honduras (UNAH), Tegucigalpa, Honduras. wendy.murillo@smi.se
authors.forename: Wendy
authors.initials: W
authors.lastname: Murillo
authors.forename: Gabriela
authors.initials: G
authors.lastname: Paz-Bailey
authors.forename: Sonia
authors.initials: S
authors.lastname: Morales
authors.forename: Edgar
authors.initials: E
authors.lastname: Monterroso
authors.forename: Mayte
authors.initials: M
authors.lastname: Paredes
authors.forename: Trudy
authors.initials: T
authors.lastname: Dobbs
authors.forename: Bharat S
authors.initials: BS
authors.lastname: Parekh
authors.forename: Jan
authors.initials: J
authors.lastname: Albert
authors.forename: Ivette Lorenzana de
authors.initials: IL
authors.lastname: Rivera
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology*; D004252:DNA Mutational Analysis; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000302:isolation & purification; D006721:Honduras / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics; D017422:Sequence Analysis, DNA; D055815:Young Adult; D054302:pol Gene Products, Human Immunodeficiency Virus / Q000235:genetics
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral; D054302:pol Gene Products, Human Immunodeficiency Virus