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. 2022 Mar 19;22(1):266.
doi: 10.1186/s12879-022-07264-y.

High prevalence of pre-treatment HIV drug resistance in Papua New Guinea: findings from the first nationally representative pre-treatment HIV drug resistance study

Janet Gare  1 , Ben Toto  2 , Percy Pokeya  3 , Linh-Vi Le  4 , Nick Dala  5 , Namarola Lote  6 , Bangan John  6 , Abel Yamba  3 , Kevin Soli  3 , Joshua DeVos  7 , Heather Paulin  8 , Nick Wagar  7 , Du-Ping Zheng  7 , Takeshi Nishijima  9 , Peniel Boas  10 , Angela Kelly-Hanku #  2   11 , Anup Gurung #  6
Affiliations

High prevalence of pre-treatment HIV drug resistance in Papua New Guinea: findings from the first nationally representative pre-treatment HIV drug resistance study

Janet Gare et al. BMC Infect Dis. .

Abstract

Background: Determining the prevalence of pre-treatment HIV drug resistance (PDR) is important to assess the effectiveness of first-line therapies. To determine PDR prevalence in Papua New Guinea (PNG), we conducted a nationally representative survey.

Methods: We used a two-stage cluster sampling method to recruit HIV treatment initiators with and without prior exposure to antiretroviral therapies (ART) in selected clinics. Dried blood spots were collected and tested for PDR.

Results: A total of 315 sequences were available for analysis. The overall PDR prevalence rate was 18.4% (95% CI 13.8-24.3%). The prevalence of PDR to non-nucleoside analog reverse-transcriptase inhibitors (NNRTIs) was 17.8% (95% CI 13.6-23.0%) and of PDR to nucleoside reverse transcriptase inhibitors (NRTIs) was 6.3% (95% CI 1.6-17.1%). The PDR prevalence rate among people reinitiating ART was 42.4% (95% CI 29.1-56.4%).

Conclusions: PNG has a high PDR prevalence rate, especially to NNRTI-based first-line therapies. Our findings suggest that removing NNRTIs as part of first-line treatment is warranted and will lead to improving viral suppression rates in PNG.

Keywords: Antiretroviral therapy; Human immunodeficiency virus; Papua New Guinea; Pre-treatment drug resistance.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
The flow chart illustrates the study participant recruitment process and the genotyping results
Fig. 2
Fig. 2
a Individual NRTI PDR mutations that were detected in 13 of the participants whilst. b Individual NNRT PDR mutations detected in 49 of the participants
See this image and copyright information in PMC

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