title: Low Rates of Transmitted Drug Resistance Among Newly Identified HIV-1 Seroconverters in Rural Rakai, Uganda.
abstract: We investigated the rate of transmitted drug resistance (TDR) among HIV-1 seroconverters identified from the Rakai Community Cohort Study (RCCS) survey, a population-based cohort in Rakai District, Uganda. Participants aged 15-49 are interviewed at study visits approximately every 12-18 months and provided a serological sample. Antiretroviral therapy (ART) has been provided free of charge since 2004. RCCS participants with documented negative HIV-1 serology between January 2011 and August 2012 and confirmed seroconversion between November 2012 and October 2013 were included in this analysis. Serum was genotyped for HIV drug resistance mutations in reverse transcriptase and protease genes. Mutations were classified according to the 2009 World Health Organization surveillance of transmitted HIV-1 drug resistance update. Seventy-five (75) seroconverters were identified and genotyped. The mean age was 28 years (range 18-49) and the majority were male, n = 44 (58%). The HIV-1 subtype frequencies were A = 19 (25%), D = 44 (59%), C = 4 (5%), A/D recombinant = 5 (7%), and C/D recombinant = 3 (4%). The majority (72/75, 96%) of individuals were infected with wild-type virus with no evidence of TDR. Two individuals had a single non-nucleoside reverse transcriptase inhibitor mutation each, K101E and K103N, and one had a single protease inhibitor mutation, M46I. No mutations were identified involving nucleoside reverse transcriptase inhibitors. In conclusion, almost 10 years after the introduction of ART in rural Uganda, rates of TDR remain low. Ongoing surveillance for TDR remains an important public health priority and should be conducted among known seroconverters to estimate TDR.
authors: 1 Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health , Bethesda, Maryland.|2 Rakai Health Sciences Program , Kalisizo, Uganda .|3 Johns Hopkins School of Medicine , Baltimore, Maryland.
authors: Steven J
authors: SJ
authors: Reynolds
authors: 4 Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc. , Frederick National Laboratory for Cancer Research, Frederick, Maryland.
authors: Victor
authors: V
authors: Ssempijja
authors: 2 Rakai Health Sciences Program , Kalisizo, Uganda .
authors: Ronald
authors: R
authors: Galiwango
authors: 2 Rakai Health Sciences Program , Kalisizo, Uganda .
authors: Anthony
authors: A
authors: Ndyanabo
authors: 2 Rakai Health Sciences Program , Kalisizo, Uganda .
authors: Gertrude
authors: G
authors: Nakigozi
authors: 5 British Medical Research Council Unit on HIV/AIDS , Entebbe, Uganda .
authors: Fred
authors: F
authors: Lyagoba
authors: 5 British Medical Research Council Unit on HIV/AIDS , Entebbe, Uganda .
authors: Jamirah
authors: J
authors: Nazziwa
authors: 1 Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health , Bethesda, Maryland.|3 Johns Hopkins School of Medicine , Baltimore, Maryland.
authors: Andrew
authors: A
authors: Redd
authors: 6 Bioinfoexperts, LLC, Thibodaux, Louisiana.
authors: Susanna L
authors: SL
authors: Lamers
authors: 7 Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors: Ron
authors: R
authors: Gray
authors: 7 Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors: Maria
authors: M
authors: Wawer
authors: 2 Rakai Health Sciences Program , Kalisizo, Uganda .|8 Makerere University School of Public Health , Kampala, Uganda .
authors: David
authors: D
authors: Serwadda
authors: 1 Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health , Bethesda, Maryland.|3 Johns Hopkins School of Medicine , Baltimore, Maryland.
authors: Thomas C
authors: TC
authors: Quinn
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D024882:Drug Resistance, Viral; D005260:Female; D060005:Genotyping Techniques; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission* / Q000821:virology*; D016333:HIV Protease / Q000235:genetics; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
chemical_list: C514824:reverse transcriptase, Human immunodeficiency virus 1; D054303:HIV Reverse Transcriptase; D016333:HIV Protease
keywords: HIV; antiretroviral therapy; drug resistance