National Prevalence of Transmitted HIV Drug Resistance in Swaziland in 2011 R. Suzanne Beard, Ph.D....
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Transcript of National Prevalence of Transmitted HIV Drug Resistance in Swaziland in 2011 R. Suzanne Beard, Ph.D....
National Prevalence of Transmitted HIV Drug Resistance
in Swaziland in 2011
R. Suzanne Beard, Ph.D.
Abstract/poster: TUPDC0103
Background Assessed the national level of transmitted drug
resistance (TDR) in recently HIV-infected adults (18-49 yrs.) using samples collected from seroconverters and acutely HIV-infected persons enrolled between 2010-2011 in the Swaziland HIV Incidence Measurement Survey (SHIMS)
18,172 adults completed household-based counseling and rapid HIV testing 13 seronegative, NAT positive (acute) 11,232 HIV-negative individuals had repeat HIV testing
six months later, 145 seroconverted (SC)
151 out of 158 HIV-positive samples were available for HIVDR analysis
Abstract/poster: TUPDC0103
Genotyping was performed with 3 assays: sequencing based (in-house), multiplex allele-specific (MAS), and allele-specific real-time PCR (AS-PCR)
detection limits of minor mutations of 20%, 1.6-12.5% and 0.2-1.7% respectively
TDR mutations were determined by Calibrated Population Resistance tool using the 2009 WHO DR mutation listAbstract/poster: TUPDC0103
Resistance Profile by Assay for Patients With TDR
Specimen # category
In-house Result
MAS Result
AS-PCR Result
20* SC K103N21 SC V106A V106AV31 SC Y181C33 SC Y181C
48 SC M46I+
72 SC V106M85 SC Y181C101 SC V106M103 SC V106M, Y181C122 SC Y181C Y181C Y181C141 acute Y181C148 acute K103N K103N K103N, Y181C151 acute Y181C148 acute K65R
4 3 13NNRTI
2.13%NNRTI
2.13% 7.91%* positive by in-house but was not successfully sequenced
designed to detect any PI mutations
Total Number of Major DR Mutations
+ the MAS-DR is not designed to detect this PI mutation and AS-PCR is not
Prevelence of TDR
Center for Global Health
Division of Global HIV/AIDS
Conclusions These findings provide the first estimate of the
national prevalence of TDR, using samples from a nationally representative cohort of HIV seroconverters and acutely HIV-infected individuals
Using WHO definitions, the TDR level in Swaziland is: low (<5%) based on the sequencing-based in-
house or more sensitive MAS assay moderate (5-15%) based on the ultrasensitive
AS-PCR Further work needs to be done to determine the
clinical significance of low-frequency DR mutations
Surveillance of TDR in recently HIV-1-infected populations can inform treatment programs on the efficacy of current ART regimens available
Abstract/poster: TUPDC0103