High levels of transmitted HIV drug resistance in a study in Papua New Guinea

Evelyn Lavu, Ellan Kave, Euodia Mosoro, Jessica Markby, Eman Aleksic, Janet Gare, Imogen A. Elsum, Gideon Nano, Petronia Kaima, Nick Dala, Anup Gurung, Silvia Bertagnolio, Suzanne M. Crowe, Mark Myatt, Anna C. Hearps, Michael R. Jordan

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Introduction: Papua New Guinea is a Pacific Island nation of 7.3 million people with an estimated HIV prevalence of 0.8%. ART initiation and monitoring are guided by clinical staging and CD4 cell counts, when available. Little is known about levels of transmitted HIV drug resistance in recently infected individuals in Papua New Guinea. Methods: Surveillance of transmitted HIV drug resistance in a total of 123 individuals recently infected with HIV and aged less than 30 years was implemented in Port Moresby (n = 62) and Mount Hagen (n = 61) during the period May 2013-April 2014. HIV drug resistance testing was performed using dried blood spots. Transmitted HIV drug resistance was defined by the presence of one or more drug resistance mutations as defined by the World Health Organization surveillance drug resistance mutations list. Results: The prevalence of non-nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 16.1% (95% CI 8.8%-27.4%) and 8.2% (95% CI 3.2%-18.2%) in Port Moresby and Mount Hagen, respectively. The prevalence of nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 3.2% (95% CI 0.2%-11.7%) and 3.3% (95% CI 0.2%-11.8%) in Port Moresby and Mount Hagen, respectively. No protease inhibitor transmitted HIV drug resistance was observed. Conclusions: The level of non-nucleoside reverse transcriptase inhibitor drug resistance in antiretroviral drug naïve individuals recently infected with HIV in Port Moresby is amongst the highest reported globally. This alarming level of transmitted HIV drug resistance in a young sexually active population threatens to limit the on-going effective use of NNRTIs as a component of first-line ART in Papua New Guinea. To support the choice of nationally recommended firstline antiretroviral therapy, representative surveillance of HIV drug resistance among antiretroviral therapy initiators in Papua New Guinea should be urgently implemented.

Original languageEnglish
Article numbere0170265
Number of pages12
JournalPLoS ONE
Volume12
Issue number2
DOIs
Publication statusPublished - 1 Feb 2017
Externally publishedYes

Cite this

Lavu, E., Kave, E., Mosoro, E., Markby, J., Aleksic, E., Gare, J., ... Jordan, M. R. (2017). High levels of transmitted HIV drug resistance in a study in Papua New Guinea. PLoS ONE, 12(2), [e0170265]. https://doi.org/10.1371/journal.pone.0170265
Lavu, Evelyn ; Kave, Ellan ; Mosoro, Euodia ; Markby, Jessica ; Aleksic, Eman ; Gare, Janet ; Elsum, Imogen A. ; Nano, Gideon ; Kaima, Petronia ; Dala, Nick ; Gurung, Anup ; Bertagnolio, Silvia ; Crowe, Suzanne M. ; Myatt, Mark ; Hearps, Anna C. ; Jordan, Michael R. / High levels of transmitted HIV drug resistance in a study in Papua New Guinea. In: PLoS ONE. 2017 ; Vol. 12, No. 2.
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title = "High levels of transmitted HIV drug resistance in a study in Papua New Guinea",
abstract = "Introduction: Papua New Guinea is a Pacific Island nation of 7.3 million people with an estimated HIV prevalence of 0.8{\%}. ART initiation and monitoring are guided by clinical staging and CD4 cell counts, when available. Little is known about levels of transmitted HIV drug resistance in recently infected individuals in Papua New Guinea. Methods: Surveillance of transmitted HIV drug resistance in a total of 123 individuals recently infected with HIV and aged less than 30 years was implemented in Port Moresby (n = 62) and Mount Hagen (n = 61) during the period May 2013-April 2014. HIV drug resistance testing was performed using dried blood spots. Transmitted HIV drug resistance was defined by the presence of one or more drug resistance mutations as defined by the World Health Organization surveillance drug resistance mutations list. Results: The prevalence of non-nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 16.1{\%} (95{\%} CI 8.8{\%}-27.4{\%}) and 8.2{\%} (95{\%} CI 3.2{\%}-18.2{\%}) in Port Moresby and Mount Hagen, respectively. The prevalence of nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 3.2{\%} (95{\%} CI 0.2{\%}-11.7{\%}) and 3.3{\%} (95{\%} CI 0.2{\%}-11.8{\%}) in Port Moresby and Mount Hagen, respectively. No protease inhibitor transmitted HIV drug resistance was observed. Conclusions: The level of non-nucleoside reverse transcriptase inhibitor drug resistance in antiretroviral drug na{\"i}ve individuals recently infected with HIV in Port Moresby is amongst the highest reported globally. This alarming level of transmitted HIV drug resistance in a young sexually active population threatens to limit the on-going effective use of NNRTIs as a component of first-line ART in Papua New Guinea. To support the choice of nationally recommended firstline antiretroviral therapy, representative surveillance of HIV drug resistance among antiretroviral therapy initiators in Papua New Guinea should be urgently implemented.",
author = "Evelyn Lavu and Ellan Kave and Euodia Mosoro and Jessica Markby and Eman Aleksic and Janet Gare and Elsum, {Imogen A.} and Gideon Nano and Petronia Kaima and Nick Dala and Anup Gurung and Silvia Bertagnolio and Crowe, {Suzanne M.} and Mark Myatt and Hearps, {Anna C.} and Jordan, {Michael R.}",
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Lavu, E, Kave, E, Mosoro, E, Markby, J, Aleksic, E, Gare, J, Elsum, IA, Nano, G, Kaima, P, Dala, N, Gurung, A, Bertagnolio, S, Crowe, SM, Myatt, M, Hearps, AC & Jordan, MR 2017, 'High levels of transmitted HIV drug resistance in a study in Papua New Guinea', PLoS ONE, vol. 12, no. 2, e0170265. https://doi.org/10.1371/journal.pone.0170265

High levels of transmitted HIV drug resistance in a study in Papua New Guinea. / Lavu, Evelyn; Kave, Ellan; Mosoro, Euodia; Markby, Jessica; Aleksic, Eman; Gare, Janet; Elsum, Imogen A.; Nano, Gideon; Kaima, Petronia; Dala, Nick; Gurung, Anup; Bertagnolio, Silvia; Crowe, Suzanne M.; Myatt, Mark; Hearps, Anna C.; Jordan, Michael R.

In: PLoS ONE, Vol. 12, No. 2, e0170265, 01.02.2017.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - High levels of transmitted HIV drug resistance in a study in Papua New Guinea

AU - Lavu, Evelyn

AU - Kave, Ellan

AU - Mosoro, Euodia

AU - Markby, Jessica

AU - Aleksic, Eman

AU - Gare, Janet

AU - Elsum, Imogen A.

AU - Nano, Gideon

AU - Kaima, Petronia

AU - Dala, Nick

AU - Gurung, Anup

AU - Bertagnolio, Silvia

AU - Crowe, Suzanne M.

AU - Myatt, Mark

AU - Hearps, Anna C.

AU - Jordan, Michael R.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Introduction: Papua New Guinea is a Pacific Island nation of 7.3 million people with an estimated HIV prevalence of 0.8%. ART initiation and monitoring are guided by clinical staging and CD4 cell counts, when available. Little is known about levels of transmitted HIV drug resistance in recently infected individuals in Papua New Guinea. Methods: Surveillance of transmitted HIV drug resistance in a total of 123 individuals recently infected with HIV and aged less than 30 years was implemented in Port Moresby (n = 62) and Mount Hagen (n = 61) during the period May 2013-April 2014. HIV drug resistance testing was performed using dried blood spots. Transmitted HIV drug resistance was defined by the presence of one or more drug resistance mutations as defined by the World Health Organization surveillance drug resistance mutations list. Results: The prevalence of non-nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 16.1% (95% CI 8.8%-27.4%) and 8.2% (95% CI 3.2%-18.2%) in Port Moresby and Mount Hagen, respectively. The prevalence of nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 3.2% (95% CI 0.2%-11.7%) and 3.3% (95% CI 0.2%-11.8%) in Port Moresby and Mount Hagen, respectively. No protease inhibitor transmitted HIV drug resistance was observed. Conclusions: The level of non-nucleoside reverse transcriptase inhibitor drug resistance in antiretroviral drug naïve individuals recently infected with HIV in Port Moresby is amongst the highest reported globally. This alarming level of transmitted HIV drug resistance in a young sexually active population threatens to limit the on-going effective use of NNRTIs as a component of first-line ART in Papua New Guinea. To support the choice of nationally recommended firstline antiretroviral therapy, representative surveillance of HIV drug resistance among antiretroviral therapy initiators in Papua New Guinea should be urgently implemented.

AB - Introduction: Papua New Guinea is a Pacific Island nation of 7.3 million people with an estimated HIV prevalence of 0.8%. ART initiation and monitoring are guided by clinical staging and CD4 cell counts, when available. Little is known about levels of transmitted HIV drug resistance in recently infected individuals in Papua New Guinea. Methods: Surveillance of transmitted HIV drug resistance in a total of 123 individuals recently infected with HIV and aged less than 30 years was implemented in Port Moresby (n = 62) and Mount Hagen (n = 61) during the period May 2013-April 2014. HIV drug resistance testing was performed using dried blood spots. Transmitted HIV drug resistance was defined by the presence of one or more drug resistance mutations as defined by the World Health Organization surveillance drug resistance mutations list. Results: The prevalence of non-nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 16.1% (95% CI 8.8%-27.4%) and 8.2% (95% CI 3.2%-18.2%) in Port Moresby and Mount Hagen, respectively. The prevalence of nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 3.2% (95% CI 0.2%-11.7%) and 3.3% (95% CI 0.2%-11.8%) in Port Moresby and Mount Hagen, respectively. No protease inhibitor transmitted HIV drug resistance was observed. Conclusions: The level of non-nucleoside reverse transcriptase inhibitor drug resistance in antiretroviral drug naïve individuals recently infected with HIV in Port Moresby is amongst the highest reported globally. This alarming level of transmitted HIV drug resistance in a young sexually active population threatens to limit the on-going effective use of NNRTIs as a component of first-line ART in Papua New Guinea. To support the choice of nationally recommended firstline antiretroviral therapy, representative surveillance of HIV drug resistance among antiretroviral therapy initiators in Papua New Guinea should be urgently implemented.

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Lavu E, Kave E, Mosoro E, Markby J, Aleksic E, Gare J et al. High levels of transmitted HIV drug resistance in a study in Papua New Guinea. PLoS ONE. 2017 Feb 1;12(2). e0170265. https://doi.org/10.1371/journal.pone.0170265