Global burden of transmitted HIV drug resistance and HIV-exposure categories: A systematic review and meta-analysis

Quang D. Pham, David P. Wilson, Matthew G. Law, Anthony D. Kelleher, Lei Zhang

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56 Citations (Scopus)

Abstract

Objectives: Our aim was to review the global disparities of transmitted HIV drug resistance (TDR) in antiretroviral-naive MSM, people who inject drugs (PWID) and heterosexual populations in both high-income and low/middle-income countries. 

Design/methods: We undertook a systematic review of the peer-reviewed English literature on TDR (1999-2013). Random-effects meta-analyses were performed to pool TDR prevalence and compare the odds of TDR across at-risk groups. 

Results: A total of 212 studies were included in this review. Areas with greatest TDR prevalence were North America (MSM: 13.7%, PWID: 9.1%, heterosexuals: 10.5%); followed by western Europe (MSM: 11.0%, PWID: 5.7%, heterosexuals: 6.9%) and South America (MSM: 8.3%, PWID: 13.5%, heterosexuals: 7.5%). Our data indicated disproportionately high TDR burdens in MSM in Oceania (Australia 15.5%), eastern Europe/central Asia (10.2%) and east Asia (7.8%). TDR epidemics have stabilized in high-income countries, with a higher prevalence (range 10.9-12.6%) in MSM than in PWID (5.2-8.3%) and heterosexuals (6.4-9.0%) over 1999-2013. In low/middleincome countries, TDR prevalence in all at-risk groups in 2009-2013 almost doubled than that in 2004-2008 (MSM: 7.8 vs. 4.2%, P=0.011; heterosexuals: 4.1 vs. 2.6%, P

Original languageEnglish
Pages (from-to)2751-2762
Number of pages12
JournalAIDS
Volume28
Issue number18
DOIs
Publication statusPublished - 28 Nov 2014
Externally publishedYes

Keywords

  • Heterosexual people
  • HIV
  • MSM
  • People who inject drugs
  • Transmitted drug resistance

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