title: Short communication: High prevalence of transmitted antiretroviral drug resistance among newly HIV type 1 diagnosed adults in Mombasa, Kenya.
abstract: Abstract   In view of the recent antiretroviral therapy (ART) scale-up in Kenya, surveillance of transmitted HIV drug resistance (TDR) is important. A cross-sectional survey was conducted among newly HIV-1 diagnosed, antiretroviral-naive adults in Mombasa, Kenya. Surveillance drug resistance mutations (SDRMs) were identified according to the 2009 WHO list. HIV-1 subtypes were determined using REGA and SCUEAL subtyping tools. Genotypic test results were obtained for 68 of 81 participants, and SDRMs were identified in 9 samples. Resistance to nonnucleoside reverse transcriptase inhibitors (K103N) occurred in five participants, yielding a TDR prevalence of 7.4% (95% confidence interval 2.4-16.3%). Frequencies of HIV-1 subtypes were A (70.6%), C (5.9%), D (2.9%), and unique recombinant forms (20.6%). The TDR prevalence found in this survey is higher than previously reported in different regions in Kenya. These findings justify increased vigilance with respect to TDR surveillance in African regions where ART programs are scaled-up in order to inform treatment guidelines.
authors.affiliation: PharmAccess Foundation, Amsterdam, The Netherlands. k.sigaloff@pharmaccess.org
authors.forename: Kim C E
authors.initials: KC
authors.lastname: Sigaloff
authors.forename: Kishor
authors.initials: K
authors.lastname: Mandaliya
authors.forename: Raph L
authors.initials: RL
authors.lastname: Hamers
authors.forename: Francis
authors.initials: F
authors.lastname: Otieno
authors.forename: Irene M
authors.initials: IM
authors.lastname: Jao
authors.forename: Frederick
authors.initials: F
authors.lastname: Lyagoba
authors.forename: Brian
authors.initials: B
authors.lastname: Magambo
authors.forename: Anne
authors.initials: A
authors.lastname: Kapaata
authors.forename: Nicaise
authors.initials: N
authors.lastname: Ndembi
authors.forename: Tobias F
authors.initials: TF
authors.lastname: Rinke de Wit
mesh_terms: D000328:Adult; D000595:Amino Acid Sequence; D019380:Anti-HIV Agents / Q000494:pharmacology*; D003430:Cross-Sectional Studies; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D005838:Genotype; D006679:HIV Seropositivity / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006297:Health Services Accessibility; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008969:Molecular Sequence Data; D009154:Mutation / Q000235:genetics; D011159:Population Surveillance; D015995:Prevalence; D012367:RNA, Viral / Q000187:drug effects
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral