使用世界卫生组织推荐的两种方法对南非经传播的HIV-1耐药性进行的省级和全国流行率估计。

Provincial and national prevalence estimates of transmitted HIV-1 drug resistance in South Africa measured using two WHO-recommended methods.

作者信息

Hunt Gillian M, Ledwaba Johanna, Kalimashe Monalisa, Salimo Anna, Cibane Siyabonga, Singh Beverly, Puren Adrian, Dean Natalie Exner, Morris Lynn, Jordan Michael R

机构信息

Centre for HIV and STIs, National Institute for Communicable Diseases, a division of the National Health Laboratory Service, Johannesburg, South Africa.

Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

Antivir Ther. 2019;24(3):203-210. doi: 10.3851/IMP3294.

DOI:10.3851/IMP3294

PMID:30741163

Abstract

BACKGROUND

Sentinel surveillance of transmitted HIV drug resistance (TDR) among recently infected populations within a country was recommended by the World Health Organization from 2004 to 2015.

METHODS

Serum specimens collected as part of the 2010, 2011 and 2012 National Antenatal Sentinel HIV Prevalence Surveys were used to estimate provincial and national TDR prevalence in South Africa.

RESULTS

Moderate (5-15%) levels of transmitted non-nucleoside reverse transcriptase inhibitor (NNRTI) drug class resistance were detected in three of five provinces surveyed in 2010 and 2011 (Eastern Cape, Free State and KwaZulu-Natal). Inclusion of all nine of South Africa's provinces in the 2012 survey enabled calculation of a national TDR point prevalence estimate: TDR to the NNRTI drug class was 5.4% (95% CI 3.7, 7.8%), with K103N and V106M being the most frequently detected mutations. TDR estimates for the nucleoside reverse transcriptase inhibitor (NRTI) drug class were 1.1% (95% CI 0.5, 2.4%) and 0.6% (95% CI 0.1, 1.6%) for protease inhibitors (PI).

CONCLUSIONS

These data provide national TDR estimates for South Africa in 2012 and indicate that levels of TDR were low to moderate for the NNRTI drug class and low for NRTIs and PIs in the population surveyed.

摘要

背景

2004年至2015年期间，世界卫生组织建议在一个国家内对近期感染人群中的传播性HIV耐药性（TDR）进行哨点监测。

方法

作为2010年、2011年和2012年全国产前哨点HIV流行率调查的一部分收集的血清标本，用于估计南非各省和全国的TDR流行率。

结果

在2010年和2011年调查的五个省份中的三个（东开普省、自由邦省和夸祖鲁-纳塔尔省）检测到中等水平（5%-15%）的传播性非核苷类逆转录酶抑制剂（NNRTI）药物类别耐药性。2012年的调查纳入了南非所有九个省份，从而能够计算出全国TDR点流行率估计值：对NNRTI药物类别的TDR为5.4%（95%置信区间3.7，7.8%），K103N和V106M是最常检测到的突变。核苷类逆转录酶抑制剂（NRTI）药物类别的TDR估计值为1.1%（95%置信区间0.5，2.4%），蛋白酶抑制剂（PI）为0.6%（95%置信区间0.1，1.6%）。