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Trends in Pretreatment HIV-1 Drug Resistance in Antiretroviral Therapy-naive Adults in South Africa, 2000-2016: A Pooled Sequence Analysis. EClinicalMedicine Chimukangara, B., Lessells, R. J., Rhee, S., Giandhari, J., Kharsany, A. B., Naidoo, K., Lewis, L., Cawood, C., Khanyile, D., Ayalew, K. A., Diallo, K., Samuel, R., Hunt, G., Vandormael, A., Stray-Pedersen, B., Gordon, M., Makadzange, T., Kiepiela, P., Ramjee, G., Ledwaba, J., Kalimashe, M., Morris, L., Parikh, U. M., Mellors, J. W., Shafer, R. W., Katzenstein, D., Moodley, P., Gupta, R. K., Pillay, D., Abdool Karim, S. S., de Oliveira, T. 2019; 9: 26–34

Abstract

Background: South Africa has the largest public antiretroviral therapy (ART) programme in the world. We assessed temporal trends in pretreatment HIV-1 drug resistance (PDR) in ART-naive adults from South Africa.Methods: We included datasets from studies conducted between 2000 and 2016, with HIV-1 pol sequences from more than ten ART-naive adults. We analysed sequences for the presence of 101 drug resistance mutations. We pooled sequences by sampling year and performed a sequence-level analysis using a generalized linear mixed model, including the dataset as a random effect.Findings: We identified 38 datasets, and retrieved 6880 HIV-1 pol sequences for analysis. The pooled annual prevalence of PDR remained below 5% until 2009, then increased to a peak of 11·9% (95% confidence interval (CI) 9·2-15·0) in 2015. The pooled annual prevalence of non-nucleoside reverse-transcriptase inhibitor (NNRTI) PDR remained below 5% until 2011, then increased to 10.0% (95% CI 8.4-11.8) by 2014. Between 2000 and 2016, there was a 1.18-fold (95% CI 1.13-1.23) annual increase in NNRTI PDR (p?

View details for DOI 10.1016/j.eclinm.2019.03.006

View details for PubMedID 31143879