AEGiS-NHIVPC: Study of Variant HIV Drug Resistant Strains in Michigan

National HIV Prevention Conference

Atlanta, Georgia, USA — July 27 - 30, 2003

Study of Variant HIV Drug Resistant Strains in Michigan

Natl HIV Prev Conf 2003 July 27-30:abstract no. TP-163
Iqbal K; Michigan Department of Community Health, Lansing, MI

BACKGROUND/OBJECTIVES:: Antiretroviral drug resistance is an important cause of treatment failure and has been associated with increased mortality among HIV-1 infected persons. Few studies have assessed the prevalence of mutations and level of drug susceptibility on newly diagnosed, drug-naive persons infected with HIV. Michigan, one of the sites for Sentinel Surveillance for Variant and Drug Resistant Strains (SSVRS), examines variant HIV drug resistant strains at the local level.

METHODS: Michigan followed the CDC SSVRS protocol in conducting the study. Blood and epidemiology data were collected on HIV infected persons diagnosed within the previous year. Enrollment from two selected HIV care clinics from 1997-2001 for individuals 18 years or older, antiretroviral drug naive, and no history of AIDS defining conditions according to CDC AIDS case definition. Reverse transcriptase (RT) and protease genotyping was conducted and plasma specimens having a RT or primary protease mutation associated with decreased drug susceptibility were tested phenotypically. All testing was conducted at the CDC and contract laboratories. Statistical analysis was ompleted to look at differences in HIV infected populations associated with decreased drug susceptibility.

RESULTS: The total enrollment of the study was 48 of which 46 (96%) were successfully amplified and genetically sequenced. Majority of the participants were men (65%) and reported a history of having sex with another man (85%). Sixty one percent of individuals had some form of mutation present, however the majority were secondary mutations. Overall 4 individuals from Michigan had a revertant strain associated with drug resistance. Of the individuals that showed decreased susceptibility to at least one drug, all were male, none were recently infected, and all were in their thirties.

CONCLUSIONS: HIV genotypic and phenotypic testing prior to the initiation of therapy in patients with infection would identify a number of infected persons with mutations associated with reduced antiretroviral susceptibility. A surveillance system is recommended to better characterize HIV among different populations and subtypes.

Keywords: HIV, HIV Infections, HIV-1, Acquired Immunodeficiency Syndrome, Anti-HIV Agents, HIV Seropositivity, Variation (Genetics), HIV Protease Inhibitors, HIV Protease, Prevalence, Mutation, Treatment Failure, Michigan, Human, Male

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TP-163