Sexual and Reproductive Health Unit, PNG Institute of Medical Research, Corner of Leigh Vial & Homate St, Goroka, Eastern Highlands Province, 441, Papua New Guinea.
United States Centres for Disease Control and Prevention Country Office of Papua New Guinea, Port Moresby, National Capital District, Papua New Guinea.
BMC Infect Dis. 2022 Mar 19;22(1):266. doi: 10.1186/s12879-022-07264-y.
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.
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.
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%).
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.
确定治疗前 HIV 耐药性（PDR）的流行率对于评估一线治疗的效果非常重要。为了确定巴布亚新几内亚（PNG）的 PDR 流行率，我们进行了一项全国代表性调查。
我们采用两阶段聚类抽样方法，在选定的诊所招募了有和没有抗逆转录病毒治疗（ART）暴露史的 HIV 治疗初治者。采集干燥血斑并进行 PDR 检测。
共分析了 315 个序列。总体 PDR 流行率为 18.4%（95%CI 13.8-24.3%）。非核苷类逆转录酶抑制剂（NNRTI）耐药的 PDR 流行率为 17.8%（95%CI 13.6-23.0%），核苷类逆转录酶抑制剂（NRTIs）耐药的 PDR 流行率为 6.3%（95%CI 1.6-17.1%）。重新开始 ART 治疗的患者的 PDR 流行率为 42.4%（95%CI 29.1-56.4%）。
PNG 的 PDR 流行率很高，特别是基于 NNRTI 的一线治疗。我们的研究结果表明，将 NNRTI 从一线治疗中去除是合理的，这将导致 PNG 的病毒抑制率提高。
