Prevalence of transmitted drug resistance associated... : AIDS (original) (raw)

Epidemiology and Social

Prevalence of transmitted drug resistance associated mutations and HIV-1 subtypes in new HIV-1 diagnoses, U.S.–2006

Wheeler, William Ha; Ziebell, Rebecca Ab; Zabina, Helenac; Pieniazek, Danutaa; Prejean, Josepha; Bodnar, Ulana Rd; Mahle, Kristen Ca; Heneine, Walida; Johnson, Jeffrey Aa; Hall, H Irenea for the Variant, Atypical, and Resistant HIV Surveillance Group

aDivision of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, USA

bThe Ginn Group Inc, Peachtree City, USA

cBusiness Computer Applications, Atlanta, Georgia, USA

dUnited States Department of Health and Human Services, Washington, DC, USA.

*The members of the Variant, Atypical, and Resistant HIV Surveillance are listed in the Acknowledgements.

Received 17 August, 2009

Revised 4 February, 2010

Accepted 9 February, 2010

Correspondence to Joseph Prejean, PhD, Centers for Disease Control and Prevention, 1600 Clifton Road NE MS E47, Atlanta, GA 30333, USA; William Wheeler, MPH, MS E-47, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA. E-mail: [email protected]

Abstract

Objective:

To determine the distribution of HIV-1 subtypes and the prevalence of transmitted drug resistance-associated mutations (TDRM) among persons newly diagnosed with HIV-1 infection in the United States.

Methods:

We used sequence data from Variant, Atypical, and Resistant HIV Surveillance (VARHS) collected from newly diagnosed persons in 10 states and 1 county health department in 2006. To evaluate TDRM, we used a mutation list for surveillance of TDRM appropriate for the primarily subtype B HIV epidemic in the United States.

Results:

Sequences were obtained from 2030 of 10 860 persons newly diagnosed with HIV in 11 surveillance areas. Mutations associated with transmitted drug resistance occurred in 292 (14.6%) persons; TDRM associated with a specific drug class occurred in 156 (7.8%) for non-nucleoside reverse transcriptase inhibitors, 111 (5.6%) for nucleoside reverse transcriptase inhibitors and 90 (4.5%) for protease inhibitors. There were no significant differences in prevalence of TDRM by demographic characteristic. The HIV-1 subtype B was the most prevalent subtype occurring in 1922 (96.2%) persons; subtype C (1.3%) was the most prevalent non-B subtype.

Conclusion:

We presented a clade B-optimized mutation list for evaluating surveillance of TDRM in the United States and analyzed the largest collection of sequence data obtained from individuals newly diagnosed with HIV. The prevalence of TDRM in persons newly diagnosed with HIV is higher than in previous U.S. studies; however, this is not necessarily a significant trend. Continued reporting of sequence data for public health purposes from all sources will improve representativeness and accuracy in analyzing trends in transmitted drug resistance and genetic diversity.