Background The first case of HIV infection in Sri Lanka was reported in 1987 and at the end of 2018 there were 3500 people living with HIV. There have been commendable efforts made towards the detection, treatment, and prevention of HIV in the country. Even though the genetic diversity of HIV has been shown to affect the parameters ranging from detection to vaccine development, there is no data available with respect to the molecular epidemiology of HIV-1 in Sri Lanka. Methods In this report we have performed the ancillary analysis of pol gene region sequences (n = 85) obtained primarily for the purpose of HIV-1 drug resistance genotyping. Briefly, dried blood spot specimens (DBS) collected from HIV-1 infected individuals between December 2015 and August 2018 were subjected to pol gene amplification and sequencing. These pol gene sequences were used to interpret the drug resistance mutation profiles. Further, sequences were subjected to HIV-1 subtyping using REGA 3.0, COMET, jPHMM and, RIP online subtyping tools. Moreover, Bayesian phylogenetic analysis was employed to estimate the evolutionary history of HIV-1 subtype C in Sri Lanka. Results Our analysis revealed that the majority (51.8%) of pol gene sequences were subtype C. Other than subtype C, there were sequences categorized as subtypes A1, B, D and G. In addition to pure subtypes there were sequences which were observed to be circulating recombinant forms (CRFs) and a few of the recombinants were identified as potential unique recombinants (URFs). We also observed the presence of drug resistance mutations in 56 (65.9%) out of 85 sequences. Estimates of the Bayesian evolutionary analysis suggested that the HIV-1 subtype C was introduced to Sri Lanka during the early 1970s (1972.8).

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Introduction: Genital warts being a common STI in the country, its impact on quality of life, and cost of care associated with it need to be studied within the current STI context in Sri Lanka.

Introduction: Sri Lanka has initiated ART programme in 2004. By the end of 2014 a total of 825 patients were receiving care services with 481 at the HIV clinic, Colombo. Based on WHO consolidated guidelines on ART published in 2013 the ART guideline was updated in 2014. It was decided to determine the response to ART among PLHIV managed according to the new guideline. The objective of the study was to determine the response to ART among adult PLHIV attending HIV clinic, NSACP. Methods: A clinic based prospective study was carried out at the main STD/HIV clinic in Colombo to assess the clinical and laboratory response to ART. All adult PLHIV who were started on ART from 1st November 2014 to 31st October 2015 were included in the study and were followed up till end October 2016. Data was collected using interviewer administered questionnaire by trained medical officers. Laboratory data and other relevant information were extracted from patient records. Ethical clearance was obtained. Results: A total of 95 patients were started ART at the HIV clinic, Colombo during this period. Majority (74%) were males with median age of 38 years. Among PLHIV 35.1% males and 24% of females were in WHO stage 3 or 4 at the time of presentation. TB was the commonest OI (10%) followed by PCP (9%). ART was started due to CD4 count< 500 cells/µl (77%), key populations (6%) and for PMTCT (5%). ART regimen had to be substituted in 7%. Adherence was satisfactory in females (88%) and males (89%). Most of the patients were on TDF+FTC+EFV regimen (67%) and this group experienced least side effects. Quality of life improved in 95%. CD4 count increased while viral load was <1000 copies/ml among 96% of those who had satisfactory adherence (n=76). Conclusion: Most patients had satisfactory adherence and clinical, immunological and virological response was satisfactory. Poor adherence need to be further analyzed. Fixed dose combination TDF+FTC+EFV was the preferred first line regimen and was well tolerated by PLHIV.

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