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Low Prevalence of Transmitted Drug Resistance of HIV-1 During 2008–2012 Antiretroviral Therapy Scaling up in Southern Vietnam

Tanuma, Junko MD, PhD*; Quang, Vo Minh MD; Hachiya, Atsuko PhD; Joya, Akane BSc*; Watanabe, Koji MD, PhD*; Gatanaga, Hiroyuki MD, PhD*; Van Vinh Chau, Nguyen MD, PhD; Chinh, Nguyen Tran MD, PhD; Oka, Shinichi MD, PhD*

JAIDS Journal of Acquired Immune Deficiency Syndromes: August 1st, 2014 - Volume 66 - Issue 4 - p 358–364
doi: 10.1097/QAI.0000000000000196
Basic and Translational Science

Background: The recent expansion of antiretroviral therapy (ART) program in resource-limited setting has raised concern about possible transmission of drug resistance (TDR). We assessed the prevalence of TDR over a 5-year period among treatment-naive individuals in Southern Vietnam during rapid ART scale-up.

Methods: Drug resistance mutations among antiretroviral-naive HIV-1–infected patients in Ho Chi Minh City were evaluated prospectively from 2008 to 2012 by HIV-1 pol gene sequencing. TDR was defined according to the World Health Organization list for surveillance of transmitted HIV-1 drug resistance in 2009.

Results: Pol sequence was obtained in 1389 individuals (median age: 30 years, males: 52.3%). Risks of HIV-1 infection included heterosexual contact in 60.7%, injection drug use in 22.4% and both 5.2%. The majority was infected with CRF01_AE (97%), whereas 19 were infected with subtype B. Over the 5-year study period, TDR was detected in 58 individuals (4.18%): 28 (2.02%) against nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), 19 (1.37%) against nonnucleoside reverse transcriptase inhibitors (NNRTIs), and 15 (1.08%) against protease inhibitors (PIs), including 4 (0.29%) against both NRTIs and NNRTIs. The most common TDR was K103N (0.5%) for NNRTI. The annual prevalence of TDR remained low to moderate (2008: 2.4%; 2009: 5.2%; 2010: 5.48%; 2011: 2.72%; 2012: 5.36%), and there was no clear trend over time.

Conclusions: There was no increase in TDR prevalence in Southern Vietnam during and after the 2008–2012 rapid scale up of ART.

*AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan;

Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam; and

Department of Infectious Diseases and Immunology, Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.

Correspondence to: Junko Tanuma, MD, PhD, AIDS Clinical Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655, Japan (e-mail:

Supported by the program of the Japan Initiative for Global Research Network on Infectious Diseases (10008050) from the Ministry of Education, Culture, Sports, Science and Technology, and the Grant for International Health Research (A22-2) from the Ministry of Health, Labour and Welfare, Government of Japan.

The authors have no conflicts of interest to disclose.

Received December 25, 2013

Accepted March 27, 2014

© 2014 by Lippincott Williams & Wilkins