Presence of HIV drug resistance in antiretroviral therapy-naive and -experienced patients from Papua New Guinea.
OBJECTIVE
The optimal benefits of antiretroviral therapy (ART) can be compromised by the emergence of HIV drug resistance (HIVDR) resulting in treatment failure. ART was introduced in Papua New Guinea (PNG) in 2004, yet biological data on HIVDR are lacking. The aim of the study was to investigate levels of HIVDR in ART-naive and -experienced patients in PNG.


METHODS
We recruited, interviewed and collected blood from 108 ART-naive and 102 ART-experienced patients from two Highlands provinces of PNG. Dried blood spots were tested for HIVDR from all patients with detectable plasma viral load of ≥200 copies/mL using established in-house assays.


RESULTS
The PCR amplification success was 90.6% (n = 96) and 66.7% (n = 12) using dried blood spots from ART-naive and -experienced patients, respectively. Transmitted drug resistance was detected in 2.1% (n = 2) of samples from ART-naive patients; acquired drug resistance was detected in 50% (n = 6) of samples from ART-experienced individuals.


CONCLUSIONS
Our data showed that transmitted drug resistance in PNG is low and acquired drug resistance is higher with 12.7% of the ART-experienced patients failing treatment. As ART access is rapidly expanding in PNG, monitoring of drug resistance is paramount for early detection of treatment failure.
Centre for Biomedical Research, Burnet Institute, Melbourne, Victoria, Australia Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea Central Clinical School, Monash University, Melbourne, Victoria, Australia jgare@burnet.edu.au.
Janet
J
Gare
Centre for Biomedical Research, Burnet Institute, Melbourne, Victoria, Australia.
Claire E
CE
Ryan
Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea.
Matthew
M
David
Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea.
Diana
D
Timbi
HIV/STI Highlands Region, National Department of Health, Mt Hagen, Western Highlands Province, Papua New Guinea.
Petronia
P
Kaima
Pathology Department, Mt Hagen General Hospital, Mt Hagen, Western Highlands Province, Papua New Guinea.
Zure
Z
Kombati
Michael Alpers Clinic, Goroka General Hospital, Goroka, Eastern Highlands Province, Papua New Guinea.
Ulato
U
Imara
Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Angela
A
Kelly-Hanku
Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea.
Peter M
PM
Siba
Centre for Biomedical Research, Burnet Institute, Melbourne, Victoria, Australia Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Suzanne M
SM
Crowe
Centre for Biomedical Research, Burnet Institute, Melbourne, Victoria, Australia Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Anna C
AC
Hearps
D000293:Adolescent; D000328:Adult; D000480:Alkynes; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D048588:Benzoxazines / Q000627:therapeutic use; D003521:Cyclopropanes; D059788:Dried Blood Spot Testing; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006679:HIV Seropositivity; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019829:Nevirapine / Q000627:therapeutic use; D010219:Papua New Guinea; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D018119:Stavudine / Q000627:therapeutic use; D017211:Treatment Failure; D019562:Viral Load; D055815:Young Adult; D015215:Zidovudine / Q000627:therapeutic use
D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D015215:Zidovudine; D019829:Nevirapine; D018119:Stavudine; C098320:efavirenz
acquired drug resistance; dried blood spots; transmitted drug resistance; treatment failure