Onywera H. auteur aut IRD Maman D. auteur aut IRD Inzaule S. auteur aut IRD Auma E. auteur aut IRD Were K. auteur aut IRD Fredrick H. auteur aut IRD Owiti P. auteur aut IRD Opollo V. auteur aut IRD Etard Jean-François auteur aut IRD Mukui I. auteur aut IRD Kim A. A. auteur aut IRD Zeh C. auteur aut IRD text journalArticle eng text/pdf reformatted digital access HIV-1 transmitted drug resistance (TDR) is of increasing public health concern in sub-Saharan Africa with the rollout of antiretroviral (ARV) therapy. Such data are, however, limited in Kenya, where HIV-1 drug resistance testing is not routinely performed. From a population-based household survey conducted between September and November 2012 in rural western Kenya, 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 Limiting Antigen and BioRad avidity immunoassays, respectively. HIV-1 po/sequences were scored for drug resistance mutations using Stanford HIVdb and WHO 2009 mutation guidelines. HIV-1 subtyping was computed in MEGA6. Eighty seven (93.5%) of the eligible samples were successfully sequenced. Of these, 8 had at least one TDR mutation, resulting in a TDR prevalence of 9.2% (95% CI 4.7-17.1). No 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 (NRTIs), 6.9% (95% CI 3.2-14.2) for non- nucleoside reverse transcriptase inhibitors (NNRTIs), and 1.2% (95% CI 0.2-6.2) for protease inhibitors. Three (3.4% 95% CI 0.8-10.1) persons had dual-class NRTI/NNRTI resistance. Predominant TDR mutations in the reverse transcriptase included K103N/S (4.6%) and M184V (2.3%); only M461/L (1.1%) occurred in the protease. All 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%). Only low CD4 count was associated with TDR (p = 0.0145). Our findings warrant the need for enhanced HIV-1 TDR monitoring in order to inform on population-based therapeutic guidelines and public health interventions. specialized KENYA 052 050 12 2 e0171124 [14 p.] 2017 1932-6203 https://www.documentation.ird.fr/hor/fdi:010069312 10.1371/journal.pone.0171124 1932-6203 [F B010069312] https://www.documentation.ird.fr/hor/fdi:010069312 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers17-03/010069312.pdf IRD - Base Horizon / Pleins textes 2017-04-04 2017-08-23 fdi:010069312 fre