173. A Retrospective Analysis of Estimated Annual Prevalence of Transmitted Drug Resistance in an HIV Cohort in Northwest Louisiana
Session: Poster Abstract Session: ART: Efficacy and Resistance
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • 173IDWPOSTER.pdf (682.7 kB)
  • Background:

    Most studies done in the United States to determine the prevalence of anti-retroviral transmitted drug resistance (TDR) in HIV infected individuals have been conducted in highly urban metropolitan areas. Fewer studies have been done in populations similar to our catchment area of Louisiana Public Health Region 7, a population of half a million residing in suburban and rural Northwestern Louisiana. Our objective was to determine the prevalence of Nucleoside reverse transcriptase inhibitor (NRTI), Non- Nucleoside reverse transcriptase inhibitor (NNRTI) and Protease inhibitor (PI) TDR in newly diagnosed HIV infected individuals and to determine any change in annual prevalence of TDR over the study period.

    Methods:

    Retrospective chart review of treatment naive HIV individuals, 18 years and older, enrolled in the viral disease clinic at Louisiana State University Health at Shreveport from January 2004 to December 2011 for whom HIV resistance testing was available prior to treatment initiation.

    Results:

    1449 charts were reviewed and 275 met the inclusion criteria. Age ranged from 18 to 62 with male to female ratio of 2:1 and African American to Caucasian ratio of 5:1.  37 of the 275 individuals had TDR with an overall prevalence of 13.4% during the study period. 32 individuals had a single class, 4 individuals had dual class and 1 individual had triple class drug resistance. Male gender, Afro-American race, Male sex with male acquisition risk and hepatitis B or C coinfection was not statistically associated with TDR.  Odds ratio for TDR for individuals enrolled in care 2009-2011 in comparison to 2006-2008 was 1.02(CI 0.5277-1.9000) p=0.9. NNRTI TDR prevalence was 7.6% and 4% for NRTI and PI. K103N was the most common mutation, identified in 18 individuals.

    Conclusion:

    Overall prevalence of TDR was 13.4% in our HIV population which is slightly lower than the 15.6% national prevalence rate according to 2006-2009 CDC National HIV surveillance data. Annual prevalence rate of TDR fluctuated and varied widely over the study period. Our TDR prevalence rate was much higher compared to studies conducted in similar sized population. Our data reaffirm the need for baseline genotype testing for TDR even in predominantly semi urban and rural HIV population.

    Andrew Chandranesan, MD, Gwendolin Tangham, MD and Madhuchhanda Choudhary, MD, Medicine, Infectious Diseases, Louisiana State University Health, Shreveport, LA

    Disclosures:

    A. Chandranesan, None

    G. Tangham, None

    M. Choudhary, None

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