@article{fdi:010069312,
  title = {{S}urveillance of {HIV}-1 pol transmitted drug resistance in acutely and recently infected antiretroviral drug-na{I}ve persons in rural western {K}enya},
  author = {{O}nywera, {H}. and {M}aman, {D}. and {I}nzaule, {S}. and {A}uma, {E}. and {W}ere, {K}. and {F}redrick, {H}. and {O}witi, {P}. and {O}pollo, {V}. and {E}tard, {J}ean-{F}ran{\c{c}}ois and {M}ukui, {I}. and {K}im, {A}. {A}. and {Z}eh, {C}.},
  editor = {},
  language = {{ENG}},
  abstract = {{HIV}-1 transmitted drug resistance ({TDR}) is of increasing public health concern in sub-{S}aharan {A}frica with the rollout of antiretroviral ({ARV}) therapy. {S}uch data are, however, limited in {K}enya, where {HIV}-1 drug resistance testing is not routinely performed. {F}rom a population-based household survey conducted between {S}eptember and {N}ovember 2012 in rural western {K}enya, we retrospectively assessed {HIV}-1 {TDR} baseline rates, its determinants, and genetic diversity among drug-na ve persons aged 15-59 years with acute {HIV}-1 infections ({AHI}) and recent {HIV}-1 infections ({RHI}) as determined by nucleic acid amplification test and both {L}imiting {A}ntigen and {B}io{R}ad avidity immunoassays, respectively. {HIV}-1 po/sequences were scored for drug resistance mutations using {S}tanford {HIV}db and {WHO} 2009 mutation guidelines. {HIV}-1 subtyping was computed in {MEGA}6. {E}ighty seven (93.5%) of the eligible samples were successfully sequenced. {O}f these, 8 had at least one {TDR} mutation, resulting in a {TDR} prevalence of 9.2% (95% {CI} 4.7-17.1). {N}o {TDR} was observed among persons with {AHI} (n = 7). {TDR} prevalence was 4.6% (95% {CI} 1.8-11.2) for nucleoside reverse transcriptase inhibitors ({NRTI}s), 6.9% (95% {CI} 3.2-14.2) for non- nucleoside reverse transcriptase inhibitors ({NNRTI}s), and 1.2% (95% {CI} 0.2-6.2) for protease inhibitors. {T}hree (3.4% 95% {CI} 0.8-10.1) persons had dual-class {NRTI}/{NNRTI} resistance. {P}redominant {TDR} mutations in the reverse transcriptase included {K}103{N}/{S} (4.6%) and {M}184{V} (2.3%); only {M}461/{L} (1.1%) occurred in the protease. {A}ll the eight persons were predicted to have different grades of resistance to the {ARV} regimens, ranging from potential low-level to high-level resistance. {HIV}-1 subtype distribution was heterogeneous: {A} (57.5%), {C} (6.9%), {D} (21.8%), {G} (2.3%), and circulating recombinant forms (11.5%). {O}nly low {CD}4 count was associated with {TDR} (p = 0.0145). {O}ur findings warrant the need for enhanced {HIV}-1 {TDR} monitoring in order to inform on population-based therapeutic guidelines and public health interventions.},
  keywords = {{KENYA}},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {12},
  numero = {2},
  pages = {e0171124 [14 p.]},
  ISSN = {1932-6203},
  year = {2017},
  DOI = {10.1371/journal.pone.0171124},
  URL = {https://www.documentation.ird.fr/hor/fdi:010069312},
}