Letter to the Editor: Antiretroviral Drug Resistance among Treatment-Naïve HIV-1-Infected Persons in Washington, D.C.

Late presentation and transmitted drug resistance mutations in new HIV-1 diagnoses in Detroit

“…Our data suggest that HIV-1 drug resistance transmission rates in Detroit are similar to those that have been observed in large metropolitan areas of the USA, such as San Francisco and Washington DC. 19,20 In this study, we did not observe any subjects with three thymidine analogue mutations (TAMS). However, 3% of subjects had two TAMS and 2% had virus with M184 V. We also observed an increased frequency of L90 M mutation: 4.5% compared to the 0.1% reported by Bennett et al 12 This high rate of L90 M mutation may possibly reflect high level usage of ritonavir-boosted protease inhibitor in our community 21,22 or the persistence of mutations selected by past saquinavir and nelfinavir usage.…”

Human immunodeficiency virus (HIV) in Washington, D.C.: Prevalence of antiretroviral resistance in treatment nave patients from 2007 to 2010

“…Our overall TDR and resistance for specific ARV classes were higher than what was previously reported for Washington, D.C. by Boyd et al (2005) and Gajjala et al (2005Gajjala et al ( -2007. (Boyd et al, 2008;Gajjala et al, 2008). Our patient population is similar to the HIV population in Washington, D.C.…”

“…The differences in TDR within our region with similar patient demographics may be related to many complicated factors such as provider preferences for ARVs during the study periods, adherence patterns, engagement in care, patient comorbidities and nonmedical issues. We did not gather additional demographic information about our subjects or look into the effect of transmission clusters, which could also lead to different results from Boyd et al (2008).…”

“…TDR in several communities has been studied but data regarding the frequency of major mutations and ARV resistance in Washington, D.C. is limited. In the retrospective review by (Boyd et al, 2008) of 42 treatment-naïve patients in Washington, D.C. who entered medical care in 2005, 7% of patients were classified as having International AIDS Society (IAS) recognized mutations detected in the reverse transcriptase (RT) region; no major mutations were detected in the protease (Pr) region. Major nucleoside reverse transcriptase inhibitor (NRTI) and non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance mutations were detected in 2.4% and 4.8% of patients, respectively (Boyd et al 2008).…”

“…In the retrospective review by (Boyd et al, 2008) of 42 treatment-naïve patients in Washington, D.C. who entered medical care in 2005, 7% of patients were classified as having International AIDS Society (IAS) recognized mutations detected in the reverse transcriptase (RT) region; no major mutations were detected in the protease (Pr) region. Major nucleoside reverse transcriptase inhibitor (NRTI) and non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance mutations were detected in 2.4% and 4.8% of patients, respectively (Boyd et al 2008). Gajjala et al (2008) identified 41 patients newly diagnosed with HIV in Washington, D.C. from 2005 to 2007; no major NRTI or Pr mutations were detected; 3 patients had major NNRTI mutations (2.4%) (Gajjala et al 2008).…”