Work

Correction: Prevalence of HIV-1 Drug Resistance among Women Screening for HIV Prevention Trials in KwaZulu-Natal, South Africa (MTN-009)

Year: 2014

Type: erratum

Abstract: Background: A major concern with using antiretroviral (ARV)-based products for HIV prevention is the potential spread of drug resistance, particularly from individuals who are HIV-infected but unaware of their status.Limited data exist on the prevalence of HIV infection or drug resistance among potential users of ARV-based prevention products. Methods:A cross-sectional study of reproductive-aged women who presented to screen for an HIV prevention trial was conducted at 7 clinical sites in Durban, South Africa.CD4+T cell counts, HIV-1 RNA levels and population sequencing of the protease and reverse transcriptase genes were performed for all women with 2 positive HIV rapid tests.Resistance mutations were identified using the Stanford Calibrated Population Resistance Tool.Results: Of the 1073 evaluable women, 400(37%) were confirmed as HIV-infected.Of those, plasma HIV-1 RNA was detectable in 365/400(91%) and undetectable(,40 copies/ml) in 35/400(9%) women.156 women(39%) were eligible for antiretroviral therapy (CD4+T cell counts,350 cells/mm 3 ) and 50(13%) met criteria for AIDS(CD4,200 cells/mm 3 ).Of 352 plasma samples(.200copies/ml) analyzed for drug resistance, 26(7.4%) had nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI) or protease inhibitor (PI) drug resistance mutations.Among those with resistance, 18/26 participants(62%) had single-class NNRTI resistance and 5/26(19%) had dual-class NRTI/NNRTI.Major mutations in reverse transcriptase included K65R(n = 1), L74I(n = 1), K103N(n = 19), V106M(n = 4), Y181C(n = 2), M184V(n = 4), and K219E/R(n = 2).Major PI-resistance mutations were rare: M46L(n = 1) and I85V(n = 1).All participants were infected with subtype C virus, except one infected with subtype A. Conclusions:In women from Durban, South Africa screening for an HIV prevention trial, the HIV prevalence was high (37%) and HIV drug resistance prevalence was above 5%.This study highlights the potential challenges faced when implementing an ARV-based prevention product that overlaps with first-line antiretroviral therapy.Effective screening to exclude HIV infection among women interested in uptake of ARV-based HIV prevention will be essential in limiting the spread of ARV resistance.

Source: PLoS ONE

DOI: 10.1371/annotation/8096d24f-06de-4e42-8834-b5d3e116253c