title: Low prevalence of transmitted drug resistance of HIV-1 during 2008-2012 antiretroviral therapy scaling up in Southern Vietnam.
abstract: BACKGROUND
  The recent expansion of antiretroviral therapy (ART) program in resource-limited setting has raised concern about possible transmission of drug resistance (TDR). We assessed the prevalence of TDR over a 5-year period among treatment-naive individuals in Southern Vietnam during rapid ART scale-up.
  
  
  METHODS
  Drug resistance mutations among antiretroviral-naive HIV-1-infected patients in Ho Chi Minh City were evaluated prospectively from 2008 to 2012 by HIV-1 pol gene sequencing. TDR was defined according to the World Health Organization list for surveillance of transmitted HIV-1 drug resistance in 2009.
  
  
  RESULTS
  Pol sequence was obtained in 1389 individuals (median age: 30 years, males: 52.3%). Risks of HIV-1 infection included heterosexual contact in 60.7%, injection drug use in 22.4% and both 5.2%. The majority was infected with CRF01_AE (97%), whereas 19 were infected with subtype B. Over the 5-year study period, TDR was detected in 58 individuals (4.18%): 28 (2.02%) against nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), 19 (1.37%) against nonnucleoside reverse transcriptase inhibitors (NNRTIs), and 15 (1.08%) against protease inhibitors (PIs), including 4 (0.29%) against both NRTIs and NNRTIs. The most common TDR was K103N (0.5%) for NNRTI. The annual prevalence of TDR remained low to moderate (2008: 2.4%; 2009: 5.2%; 2010: 5.48%; 2011: 2.72%; 2012: 5.36%), and there was no clear trend over time.
  
  
  CONCLUSIONS
  There was no increase in TDR prevalence in Southern Vietnam during and after the 2008-2012 rapid scale up of ART.
authors.affiliation: *AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan; †Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam; and ‡Department of Infectious Diseases and Immunology, Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Tanuma
authors.forename: Vo Minh
authors.initials: VM
authors.lastname: Quang
authors.forename: Atsuko
authors.initials: A
authors.lastname: Hachiya
authors.forename: Akane
authors.initials: A
authors.lastname: Joya
authors.forename: Koji
authors.initials: K
authors.lastname: Watanabe
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Gatanaga
authors.forename: Nguyen
authors.initials: N
authors.lastname: Van Vinh Chau
authors.forename: Nguyen Tran
authors.initials: NT
authors.lastname: Chinh
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oka
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008297:Male; D009154:Mutation; D015995:Prevalence; D014744:Vietnam / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents