1. Transmitted Drug Resistance Among Human Immunodeficiency Virus (HIV)-1 Diagnoses in the United States, 2014–2018.
- Author
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McClung, R Paul, Oster, Alexandra M, Ocfemia, M Cheryl Bañez, Saduvala, Neeraja, Heneine, Walid, Johnson, Jeffrey A, and Hernandez, Angela L
- Subjects
DIAGNOSIS of HIV infections ,ANTI-HIV agents ,PUBLIC health surveillance ,GENETIC mutation ,PUBLIC health ,DISEASE susceptibility ,DESCRIPTIVE statistics ,DRUG resistance in microorganisms ,PHARMACODYNAMICS - Abstract
Background Transmitted human immunodeficiency virus (HIV) drug resistance can threaten the efficacy of antiretroviral therapy and pre-exposure prophylaxis (PrEP). Drug-resistance testing is recommended at entry to HIV care in the United States and provides valuable insight for clinical decision making and population-level monitoring. Methods We assessed transmitted drug-resistance–associated mutation (TDRM) prevalence and predicted susceptibility to common HIV drugs among US persons with HIV diagnosed during 2014–2018 who had a drug resistance test performed ≤3 months after HIV diagnosis and reported to the National HIV Surveillance System and who resided in 28 jurisdictions where ≥20% of HIV diagnoses had an eligible sequence during this period. Results Of 50 747 persons in the analysis, 9616 (18.9%) had ≥1 TDRM. TDRM prevalence was 0.8% for integrase strand transfer inhibitors (INSTIs), 4.2% for protease inhibitors, 6.9% for nucleoside reverse transcriptase inhibitors (NRTIs), and 12.0% for non-NRTIs. Most individual mutations had a prevalence <1.0% including M184V (0.9%) and K65R (0.1%); K103N was most prevalent (8.6%). TDRM prevalence did not increase or decrease significantly during 2014–2018 overall, for individual drug classes, or for key individual mutations except for M184V (12.9% increase per year; 95% confidence interval, 5.6–20.6%). Conclusions TDRM prevalence overall and for individual drug classes remained stable during 2014–2018; transmitted INSTI resistance was uncommon. Continued population-level monitoring of INSTI and NRTI mutations, especially M184V and K65R, is warranted amidst expanding use of second-generation INSTIs and PrEP. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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