title: Transmitted HIV drug resistance at the Thai Red Cross anonymous clinic in Bangkok: results from three consecutive years of annual surveillance.
abstract: OBJECTIVE
  The aim of this study was to prospectively survey transmitted drug resistance (TDR) among recently infected individuals (mostly MSM).
  
  
  METHODS
  TDR was determined in prospective annual cohorts of recently HIV-1-infected individuals consecutively recruited from 2008 to 2010. Resistance interpretation was carried out using Stanford Database tools and the WHO surveillance drug resistance mutation list. Kruskal-Wallis and Fisher's exact tests were used to compare demographic and laboratory outcomes.
  
  
  RESULTS
  A total of 299 subjects were enrolled, with 89% MSM. Median viral load was significantly higher in 2010 than in 2008 (P=0.004). Of the 284 analysable reverse transcriptase/protease sequences, TDR to any drug was found in 14/284 (4.9%); 4.0% in 2008, 5.9% in 2009 and 5.3% in 2010, with an increasing trend of TDR to NRTIs and NNRTIs from 2008 to 2010 (P=0.07). Good correlation was found between our data and the WHO threshold surveillance method. Only rilpivirine had significantly higher (P<0.05) predicted resistance in 2010 than in 2008 and 2009.
  
  
  CONCLUSIONS
  A trend towards an increase in TDR in Thailand where the major epidemic is among MSM was observed, but did not reach the WHO-defined high-level threshold (>15%). Attention to prevent the development and spread of drug resistance is needed.
authors.affiliation: Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Sunee
authors.initials: S
authors.lastname: Sirivichayakul
authors.affiliation: Alpert Medical School, Brown University, Providence, RI, USA.
authors.forename: Rami
authors.initials: R
authors.lastname: Kantor
authors.affiliation: Alpert Medical School, Brown University, Providence, RI, USA.
authors.forename: Allison K
authors.initials: AK
authors.lastname: DeLong
authors.affiliation: The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
authors.forename: Rapeeporn
authors.initials: R
authors.lastname: Wongkunya
authors.affiliation: Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Suwanna
authors.initials: S
authors.lastname: Mekprasan
authors.affiliation: Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
authors.forename: Kiat
authors.initials: K
authors.lastname: Ruxrungtham
authors.affiliation: TREAT Asia, amfAR, The Foundation for AIDS Research, Bangkok, Thailand.
authors.forename: Annette H
authors.initials: AH
authors.lastname: Sohn
authors.affiliation: Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand The Thai Red Cross AIDS Research Centre, Bangkok, Thailand praphan.p@chula.ac.th.
authors.forename: Praphan
authors.initials: P
authors.lastname: Phanuphak
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D015331:Cohort Studies; D024882:Drug Resistance, Viral; D062665:Epidemiological Monitoring; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission* / Q000821:virology*; D015497:HIV-1 / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D015995:Prevalence; D011446:Prospective Studies; D012011:Red Cross; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
keywords: Thailand; recent infection; surveillance drug resistance mutation; transmitted drug resistance