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

Abstract

Late diagnosis of HIV-1 and transmitted antiretroviral resistance are relatively common in Detroit. While most newly diagnosed persons were candidates for antiretroviral therapy on presentation, the high prevalence of TDRM has significant implications in the selection of first-line highly active antiretroviral therapy (HAART).

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

“…However, our overall TDR data mirror the mutation rates reported in other studies within the United States (Castor et al, 2012;Huaman et al, 2011;Hurt et al, 2009;Little et al, 1999;Little et al, 2002;MacVeigh et al, 2013;Readhead et al, 2012;Ross et al, 2007;Truong et al, 2011;Weinstock et al, 2000;Weinstock et al, 2004;Wheeler et al, 2010;Yanik et al, 2012;Youmans et al, 2011).…”

“…In addition, our rate of 15% NNRTI mutations contributing to NNRTI resistance was higher than what was typically reported for this drug class (Castor et al, 2012;Huaman et al, 2011;Hurt et al, 2009;Little et al, 2002;MacVeigh et al, 2013;Readhead et al, 2012;Ross et al, 2007;Taniguchi et al, 2012;Truong et al, 2011;Weinstock et al, 2000;Weinstock et al, 2004;Wheeler et al, 2010;Yanik et al, 2012;Youmans et al, 2011). The increase in TDR was primarily due to NNRTI mutations and occurred during the 4-year study period in a trend similar to other studies in the United States (Grant et al, 2002;Ross et al, 2008;Shet et al, 2006;Simon et al, 2002).…”

“…We observed low rates of individual major Pr mutations, all below 1%; our overall rate of 2% major Pr mutations is slightly less than many other studies in the United States (Castor et al, 2012;Huaman et al, 2011;Hurt et al, 2009;Little et al, 2002;MacVeigh et al, 2013;Readhead et al, 2012;Ross et al, 2007;Taniguchi et al, 2012;Truong et al, 2011;Weinstock et al, 2000;Weinstock et al, 2004;Wheeler et al, 2010;Yanik et al, 2012;Youmans et al, 2011). Although in the minority, persons with dual and triple class ARV resistance mutations were seen in 2% (8 patients) and 0.7% (3 patients), respectively.…”

“…The most commonly detected RT mutations in our study were M41L for NRTIs and K103N for NNRTIs, which are among the most frequently reported in many studies (Castor et al, 2012;Huaman et al, 2011;Hurt et al, 2009;Little et al, 2002;MacVeigh et al, 2013;Readhead et al, 2012;Ross et al, 2007;Taniguchi et al, 2012;Truong et al, 2011;Weinstock et al, 2004;Wheeler et al, 2010;Yanik et al, 2012;Youmans et al, 2011). We observed low rates of individual major Pr mutations, all below 1%; our overall rate of 2% major Pr mutations is slightly less than many other studies in the United States (Castor et al, 2012;Huaman et al, 2011;Hurt et al, 2009;Little et al, 2002;MacVeigh et al, 2013;Readhead et al, 2012;Ross et al, 2007;Taniguchi et al, 2012;Truong et al, 2011;Weinstock et al, 2000;Weinstock et al, 2004;Wheeler et al, 2010;Yanik et al, 2012;Youmans et al, 2011).…”

“…Based on United States Department of Health and Human Services (DHHS) guidelines, genotypic antiretroviral resistance testing (GART) was initially given CIII and DIII recommendations in 2000 for acutely-infected and chronically-infected treatment-naïve patients, (DHHS, 2007). For ARV treatment naïve individuals in the U.S., TDR mutation rates have ranged from about 5% to as high as 25% (Castor et al, 2012;Huaman et al, 2011;Hurt et al, 2009;Little et al, 1999;Little et al, 2002;MacVeigh et al, 2013;Readhead et al, 2012;Ross et al, 2007;Taniguchi et al, 2012;Truong et al, 2011;Weinstock et al, 2000;Weinstock et al, 2004;Wheeler et al, 2010;Yanik et al, 2012;Youmans et al, 2011). TDR has several important implications.…”