Journal of Antivirals & Antiretrovirals
Open Access

Abstract

Prevalence of Transmitted HIV-1 Drug Resistance (TDR) Associated Mutations and Predicted Drug Sensitivity in Newly Diagnosed HIV-1 Patient Cohort in a Western New York, 2005-2011

Lili Dai, Supriya D Mahajan, Donald L Sykes, Alyssa Shon, Stanley A Schwartz, Ning Li, Hao Wu and Chiu-Bin Hsiao

HIV-1 drug resistance associated mutations can be transmitted to persons who are antiretroviral-naive, called Transmitted Drug Resistance (TDR). TDR has the potential to compromise first-line anti-retroviral therapy (ART) in HIV patients and limit the antiretroviral regimens options, which has become an important public health problem. TDR surveillance is an important strategy to monitor the emergence of genetic. TDR has been reported in the United States for many years. Current antiretroviral treatment guidelines recommend drug resistance testing after diagnosis. We did a retrospective analysis of the genotype database of ART-naïve patients from our immunodeficiency clinics at the Erie County Medical Center (ECMC) in Buffalo, New York, United States from 2005 to 2011. The prevalence of TDR in the ECMC-US cohort is still high 13.3%. The drug susceptibility is significantly reduced in 10.9% patients. The mutations were mostly “old” drug (such as AZT, D4T, EFV, NVP, SQV/r) related, while most of the “new” drugs (such as TDF, RPV, DRV/r) maintained sensitivity. The introduction of new second, third generation drugs in recent years has not brought down the prevalence of TDR significantly. The TDR prevalence rates in the United States are indicative of the fact that drug resistant mutations were generated before or at the beginning of ART and transmitted down from one generation to the other in ART naive patients, emphasizing that additional management strategies are needed to diagnose HIV infected patients earlier and to effectively treat them timely to further reduce TDR.