National prevalence and trends of HIV transmitted drug resistance in Mexico

Transmitted drug resistance (TDR) remains an important concern for the management of HIV infection, especially in countries that have recently scaled-up antiretroviral treatment (ART) access. We designed a study to assess HIV diversity and transmitted drug resistance (TDR) prevalence and trends in M...

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Bibliographic Details
Published in:PloS one 2011-11, Vol.6 (11), p.e27812-e27812
Main Authors: Avila-Ríos, Santiago, García-Morales, Claudia, Garrido-Rodríguez, Daniela, Ormsby, Christopher E, Hernández-Juan, Ramón, Andrade-Villanueva, Jaime, González-Hernández, Luz A, Torres-Escobar, Indiana, Navarro-Álvarez, Samuel, Reyes-Terán, Gustavo
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adult
AIDS
Anti-HIV Agents - pharmacology
Antiretroviral agents
Antiretroviral drugs
Automation
Bioinformatics
Biology
Clustering
Cohort Studies
DNA-Directed RNA Polymerases - blood
Donations
Drug resistance
Drug Resistance, Viral - genetics
Drug therapy
Epidemics - statistics & numerical data
Epidemiology
Female
Genetic Variation
Health aspects
Highly active antiretroviral therapy
HIV
HIV infections
HIV Infections - blood
HIV Infections - transmission
HIV-1 - classification
HIV-1 - drug effects
HIV-1 - enzymology
HIV-1 - genetics
Hospitals
Human immunodeficiency virus
Humans
Infection
Infections
Laboratories
Male
Medical diagnosis
Medical research
Medicine
Mexico - epidemiology
Mutation
Phylogenetics
Phylogeny
Prevalence
Respiratory diseases
Surveillance
Trends
Viruses
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Summary:Transmitted drug resistance (TDR) remains an important concern for the management of HIV infection, especially in countries that have recently scaled-up antiretroviral treatment (ART) access. We designed a study to assess HIV diversity and transmitted drug resistance (TDR) prevalence and trends in Mexico. 1655 ART-naïve patients from 12 Mexican states were enrolled from 2005 to 2010. TDR was assessed from plasma HIV pol sequences using Stanford scores and the WHO TDR surveillance mutation list. TDR prevalence fluctuations over back-projected dates of infection were tested. HIV subtype B was highly prevalent in Mexico (99.9%). TDR prevalence (Stanford score>15) in the country for the study period was 7.4% (95% CI, 6.2∶8.8) and 6.8% (95% CI, 5.7∶8.2) based on the WHO TDR surveillance mutation list. NRTI TDR was the highest (4.2%), followed by NNRTI (2.5%) and PI (1.7%) TDR. Increasing trends for NNRTI (p = 0.0456) and PI (p = 0.0061) major TDR mutations were observed at the national level. Clustering of viruses containing minor TDR mutations was observed with some apparent transmission pairs and geographical effects. TDR prevalence in Mexico remains at the intermediate level and is slightly lower than that observed in industrialized countries. Whether regional variations in TDR trends are associated with differences in antiretroviral drug usage/ART efficacy or with local features of viral evolution remains to be further addressed.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0027812