415. Prevalence of Antiretroviral Drug Resistance Mutations in Antiretroviral-Naïve HIV-1 Infected Persons in Newark, New Jersey
Session: Poster Abstract Session: HIV - Antiretroviral Therapy
Friday, October 21, 2011
Room: Poster Hall B1
Background: The prevalence of transmitted drug resistance mutations (TDRM) in Newark, New Jersey was reported as 6.5% when assessed 1997-2001.  Current TDRM prevalence in Newark is unknown. 

Methods: A retrospective chart review using the 2009 World Health Organization list of drug resistance mutations, evaluated TDRM in HIV-1 infected patients presenting to the University Hospital Infectious Diseases Practice (IDP) between January 2005 and December 2009.    Eligible patients had an HIV genotype report performed before ever taking any antiretroviral therapy (ART).  Descriptive statistics  are used and univariate and multivariate analyses assess associations of the following factors with presence of TDRM: age, sex, HIV risk behavior, race/ethnicity, nadir CD4 and HIV viral load. 

Results: Of 1347 HIV-1 patients presenting to the IDP, 393 had HIV genotypes and were ART naïve.  Of these, 222 (56%) were men, 315 (80%) non-Hispanic blacks, 239 (61%) reported heterosexual HIV acquisition, and 44 (11%) intravenous drug use (IDU). TDRMs were present in 44 (11%), including 30 (8%) with mutations to non-nucleoside reverse transcriptase inhibitors (NNRTIs), 11 (3%) to nucleoside reverse transcriptase inhibitors (NRTIs), and 8 (2%) to protease inhibitors. Thirty-nine (10%) had mutations to a single drug class and 5 (1%) to 2 drug classes; there was no triple class resistance. K103N mutation (precluding 1st generation NNRTI use) was observed in (14/30) 47% of those with NNRTI resistance, and M41L (conferring low level resistance to the thymidine analogs) was observed in (7/11) 64% of patients with NRTI resistance.  Race was the only factor associated with TDRM (p=0.01 ) in the univariate analysis and it remained marginally significant in the multivariate analysis (p=0.05).

Conclusion: TDRM occurs in roughly 1 of every 9 HIV-1 infected ART-naive IDP patients. This prevalence appears to be increased from an assessment of TDRM in Newark approximately 10 years ago. 


Subject Category: H. HIV/AIDS and other retroviruses

Amina Goodwin-Fernandez, MD, Infectious Diseases, University of Medicine and Dentistry, New Jersey, Newark, NJ, Shobha Swaminathan, MD, UMDNJ - New Jersey Medical School, Newark, NJ, Helen Fernandes, PhD, Molecular Diagnostics Lab, University of Medicine and Dentistry, New Jersey, Newark, NJ and Sally Hodder, MD, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ

Disclosures:

A. Goodwin-Fernandez, None

S. Swaminathan, None

H. Fernandes, None

S. Hodder, None

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