1500. Primary HIV Drug Resistance in Houston, Texas: An Update for 2015
Session: Poster Abstract Session: HIV Drug Resistance
Friday, October 28, 2016
Room: Poster Hall
Transmitted drug resistance (TDR) in Houston, Texas: An update for 2015

 Fareed Khawaja1, Karen J. Vigil1, Roberto C. Arduino1

1The University of Texas Health Science Center in Houston

Background: Increases in nonnucleoside reverse transcriptase inhibitors (NNRTI) and protease inhibitor (PI) resistance have been observed among antiretroviral treatment (ART) naïve HIV-infected individuals, whereas resistance to nucleoside reverse transcriptase inhibitors (NRTI) has been decreasing. A similar phenomenon has been observed in Houston in previous studies in 2011. Continued surveillance of transmitted drug resistance (TDR) incidence guides in the selection of first line ART. The goal of this study is to assess the incidence of TDR in ART-naive HIV-infected individuals in 2015 and compare to previous years.

Methods: Cross sectional study. All new ART-naive patients at a single HIV county clinic in Houston, Texas, from Jan 1, 2015 to Dec 31, 2015, who had HIV resistance testing were included. Demographics, baseline CD4 cell count, HIV RNA levels and risk factors were collected. Incidences of TDR and associated mutatoins were calculated. Previous studies performed at the same site were conducted similarly but over different time periods (1999, 2003-2004, 2004-2006 and 2011)

Results: A total of 358 ART-naïve subjects were included for the final analysis. The table shows a comparison of drug resistance between 2015 and prior studies. In 2015, 17% of ART-naïve HIV infected patients were infected with HIV-1 carrying TDR, similar to 2011. NNRTIs mutations had the highest prevalence (12%), followed by PIs (4.5%) and NRTIs (1.1%). The percentage of TDR to one class of drugs over the entire period was 12%; 2-drug class was 1.3%; and 3-drug class was only 0.2%. As reported before, K103N was the most common TDR present in 6.4% of HIV genotypes in our cohort. Neither ethnicity, gender identity, CD4 cell count, presence of sexual transmitted diseases or hepatitis co-infection was a risk factor for TDR.

Percentage of subjects

Drug class

1999

N=44

2003-2004

N=40

2004-2006

N= 66

2011

N=100

2015

N=358

P

Overall TDR (all classes), %

11

12

8

17

17

0.31

NNRTI, %

2.5

4.5

4.5

15

12

0.04

PI, %

2.5

4.5

3

0

4.5

0.2

NRTI, %

4.5

2.5

0

2

1.1

0.003

Conclusion: TDR in 2015 remained stable when compared to previous years. NNRTI resistance continues to adversely impact the use of NNRTI containing regimen as first line therapy for HIV.

 

Fareed Khawaja, MD, Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX, Karen J. Vigil, MD, The University of Texas Health Science Center at Houston, Houston, TX and Roberto Arduino, MD, Internal Medicine/Infectious Diseases, The University of Texas Health Science Center at Houston, Houston, TX

Disclosures:

F. Khawaja, None

K. J. Vigil, None

R. Arduino, None

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