Declining trend in transmitted drug resistance detected in a prospective cohort study of acute HIV infection in Bangkok, Thailand

Colby, Donn; Crowell, Trevor A; Sirivichayakul, Sunee; Pinyakorn, Suteeraporn; Kroon, Eugène; Benjapornpong, Khunthalee; Intasan, Jintana; Trichavaroj, Rapee; Tovanabutra, Sodsai; Robb, Merlin L.; Phanuphak, Praphan; Ananworanich, Jintanat; Phanuphak, Nittaya

doi:10.7448/ias.19.1.20966

Cited by 11 publications

(22 citation statements)

References 35 publications

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“…Anticipated risk compensation (the possibility of not using condoms while on PrEP) was associated with willingness in Brazil and Mexico but not in Peru. Risk compensation is a recurrent concern related to PrEP, and evidence of this was recently observed in other studies [33,34]; conversely, there was no statistically significant increase in condomless receptive anal sex during the PrEP Brazil study [35] or in a study conducted in Thailand [36]. Risk compensation continues to require monitoring and adequate PrEP education.…”

Section: Discussionmentioning

confidence: 89%

Factors Associated With Willingness to Use Pre-Exposure Prophylaxis in Brazil, Mexico, and Peru: Web-Based Survey Among Men Who Have Sex With Men

Ka²,

Vega-Ramírez³

et al. 2019

JMIR Public Health Surveill

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Background HIV disproportionally affects key populations including men who have sex with men (MSM). HIV prevalence among MSM varies from 17% in Brazil and Mexico to 13% in Peru, whereas it is below 0.5% for the general population in each country. Pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir is being implemented in the context of combination HIV prevention. Reports on willingness to use PrEP among MSM have started to emerge over the last few years. Previously reported factors associated with willingness to use PrEP include awareness, higher sexual risk behavior, and previous sexually transmitted infection. Objective This study aimed to evaluate the factors associated with willingness to use daily oral PrEP among MSM in 3 Latin American, middle-income countries (Brazil, Mexico, and Peru). Methods This Web-based, cross-sectional survey was advertised in 2 gay social network apps (Grindr and Hornet) used by MSM to find sexual partners and on Facebook during 2 months in 2018. Inclusion criteria were being 18 years or older, cisgender men, and HIV-negative by self-report. Eligible individuals answered questions on demographics, behavior, and PrEP (awareness, willingness to use, barriers, and facilitators). Multivariable logistic regression modeling was performed to assess the factors associated with willingness to use daily oral PrEP in each country. Results From a total sample of 43,687 individuals, 44.54% of MSM (19,457/43,687) were eligible and completed the Web-based survey—Brazil: 58.42% (11,367/19,457), Mexico: 30.50% (5934/19,457), and Peru: 11.08% (2156/19,457); median age was 28 years (interquartile range: 24-34), and almost half lived in large urban cities. Most participants were recruited on Grindr (69%, 13,349/19,457). Almost 20% (3862/19,352) had never tested for HIV, and condomless receptive anal sex was reported by 40% (7755/19,326) in the previous 6 months. Whereas 67.51% (13,110/19,376) would be eligible for PrEP, only 9.80% (1858/18,959) of participants had high HIV risk perception. PrEP awareness was reported by 64.92% (12,592/19,396); this was lower in Peru (46.60%, 1002/2156). Overall, willingness to use PrEP was reported by 64.23% (12,498/19,457); it was highest in Mexico (70%, 4158/5934) and lowest in Peru (58%, 1241/2156). In multivariate regression models adjusted for age, schooling, and income in each country, willingness to use PrEP was positively associated with PrEP awareness and PrEP facilitators (eg, free PrEP and HIV testing) and negatively associated with behavioral (eg, concerned by daily pill regimen) and belief barriers (eg, sexual partners may expect condomless sex). Conclusions In this first cross-country, Web-based survey in Latin America, willingness to use PrEP was found to be high and directly related to PrEP awareness. Interventions to increase awareness and PrEP knowledge about safety and efficacy are crucial to increase PrEP dem...

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Section: Discussionmentioning

confidence: 89%

Factors Associated With Willingness to Use Pre-Exposure Prophylaxis in Brazil, Mexico, and Peru: Web-Based Survey Among Men Who Have Sex With Men

Ka²,

Vega-Ramírez³

et al. 2019

JMIR Public Health Surveill

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“…Irrespective of the sequencing method used, the prevalence of TDRM among recently infected individuals was higher in 2008–2014 as compared to the earlier period, and significantly more patients diagnosed in this later period had multiple TDRM. Other studies report reduction in the overall prevalence of PI, NRTI and NNRTI TDRM with time [ 25 , 28 ] or stability in their prevalence [ 1 ], observations typically attributed to changes in treatment regimens which improved patient adherence. The inclining trend in TDRM prevalence identified in Israel, together with the steady increase in the number of overall new infections identified in 2008–2014 as compared to 2000–2007 (3144 versus 2686 HIV-1-positive individuals), warrants continuous monitoring of pretherapy drug resistance.…”

Section: Discussionmentioning

confidence: 99%

Comparison between next‐generation and Sanger‐based sequencing for the detection of transmitted drug‐resistance mutations among recently infected HIV‐1 patients in Israel, 2000–2014

Moscona

Ram

Wax

et al. 2017

Journal of the International AIDS Society

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Introduction: Transmitted drug-resistance mutations (TDRM) may hamper successful anti-HIV-1 therapy and impact future control of the HIV-1 epidemic. Recently infected, therapy-naïve individuals are best suited for surveillance of such TDRM. In this study, TDRM, detected by next-generation sequencing (NGS) were compared to those identified by Sanger-based population sequencing (SBS) in recently infected HIV-1 patients.Methods: Historical samples from 80 recently infected HIV-1 patients, diagnosed between 2000 and 2014, were analysed by MiSeq (NGS) and ABI (SBS). DeepChek-HIV (ABL) was used for interpretation of the results.Results: Most patients were males (80%); Men who have sex with men (MSM) was the major transmission group (58.8%). Overall, TDRM were detected in 31.3% of patients by NGS and 8.8% by SBS, with SBS TDRM restricted to persons infected with subtype B. All SBS-detected TDRM were identified by NGS. The prevalence of TDRM impacting protease inhibitors (PI), nucleoside reverse transcriptase inhibitors (NRTI) and non-nucleoside reverse transcriptase inhibitors (NNRTI) was 11.3, 26.2 7.5%, respectively, in NGS analyses and 0, 3.8 and 5%, respectively, in SBS analyses. More patients with NGS and SBS TDRM were identified in 2008–2014 (37.2% or 13.9%, respectively) compared to 2000–2007 (24.3% or 2.7%, respectively), and a significantly greater number of these patients had multiple NGS TDRM. The most abundant, albeit, minor-frequency RT TDRM, were the K65R and D67N, while K103N, M184V and T215S were high-frequency mutations. Minor TDRM did not become a major variant in later samples and did not hinder successful treatment.Conclusions: NGS can replace SBS for mutation detection and allows for the detection of low-frequency TDRM not identified by SBS. Although rates of TDRM in Israel continued to increase from 2000 to 2014, minor TDRM did not become major species. The need for ongoing surveillance of low-frequency TDRM should be revisited in a larger study.

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“…The pooled TDRAMs of NRTIs is 3.4% (95%CI: 1.8-5.0%, p < 0.001) ( Fig. 4) reported in 10 studies [1,2,20,[22][23][24][25][26][27][28]. Among 3260 patients, the most common TDRAMs for the NRTIs are T215C/D/E/F/I/S/V/Y mutations (2.4% patients), followed by M41L (1.6%), which mainly produce resistance to zidovudine and stavudine.…”

Section: Tdr Of Nrtismentioning

confidence: 87%

“…The random-effects model to get the overall prevalence of TDR is 9.8% (95% CI: 7.2-12.3%, p < 0.001) ( Fig. 2) among 9 studies [1,2,10,20,23,[25][26][27][28], which shows a higher result in developed countries (10.5%, 6.4-14.5%, p < 0.001) ( Fig. S1) than that in developing nations (9.4%, 5.9-12.9%, p < 0.001) ( Fig.…”

Section: Study Included and Characteristicsmentioning

confidence: 99%

“…Mathematical models also have proposed that treatment failure in patients who have not undergone ART was most likely to be caused by the preexistence of resistant mutants [9]. It reminds us that patients with acute HIV infection (AHI) offer an occasion for real-time monitoring of TDR [2]. Previous studies have shown that the prevalence of TDR during AHI is higher than that in patients with chronic HIV infections [10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transmitted drug resistance in ART-naive persons with acute/ early/ primary HIV infection: a systematic review and meta-analysis

Guo¹,

Wu²,

Zhang³

et al. 2021

Preprint

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Background: In the absence of AIDS vaccine，antiretroviral therapy (ART) was the most effective tool to prevent and control the HIV pandemic. But the widespread use of ART has raised concerns about the emergence of HIV transmitted drug resistance (TDR). Acute HIV infection (AHI) was the most appropriate time to detect the spread of TDR. In this meta-analysis, our purpose was to evaluate the level of TDR in ART-naive patients with acute/ primary/ early HIV infection, and describe the critical drug-resistant mutations. Methods: We systematically reviewed 1192 studies published between January 1, 2008 and December 30, 2019 in PubMed, Web of Science, Embase, and the Cochrane Library, and selected 12 studies that meet our inclusion criteria. To evaluate the overall prevalence of TDR, we extracted raw data and analyzed prevalence estimates using Stata SE. Estimates of mixed-effects were calculated by random-effects meta-analysis, and the I²statistics were used to estimate the heterogeneity of all included studies.Results: The Data of this meta-analysis come from 12 observational studies, covering 3558 ART-naive individuals with PHI, AHI or EHI. The overall prevalence of HIV-TDR is 9.8% (95% confidence interval (CI): 7.2%–12.3%, p<0.001). Prevalence of resistance by drug class is highest for the NNRTIs at 5.9% (95% CI: 3.1%–8.6%, p<0.001), followed by NRTIs 3.4% (95% CI: 1.8%–5.0%, p<0.001) and PIs 3.4% (95% CI: 2.7%–4.0%, p<0.001). The prevalence of TDR to INIs is 0.3% (95% CI: -0.1%-0.7%, p<0.001), which is the lowest among all antiretroviral drugs.Conclusion: The overall prevalence of TDR is high among AHI patients who have never received ART. This emphasizes the importance of baseline drug resistance testing for public health surveillance and guiding the choice of ART. In addition, the prevalence of TDR to NNRTIs is the highest, while the TDR to INIs is the lowest. This may guide the selection of clinical antiretroviral drugs.

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Declining trend in transmitted drug resistance detected in a prospective cohort study of acute HIV infection in Bangkok, Thailand

Cited by 11 publications

References 35 publications

Factors Associated With Willingness to Use Pre-Exposure Prophylaxis in Brazil, Mexico, and Peru: Web-Based Survey Among Men Who Have Sex With Men

Factors Associated With Willingness to Use Pre-Exposure Prophylaxis in Brazil, Mexico, and Peru: Web-Based Survey Among Men Who Have Sex With Men

Comparison between next‐generation and Sanger‐based sequencing for the detection of transmitted drug‐resistance mutations among recently infected HIV‐1 patients in Israel, 2000–2014

Transmitted drug resistance in ART-naive persons with acute/ early/ primary HIV infection: a systematic review and meta-analysis

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