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Routine surveillance for the detection of acute and recent HIV infections and transmission of antiretroviral resistance.
- Source :
-
AIDS (London, England) [AIDS] 2006 Nov 14; Vol. 20 (17), pp. 2193-7. - Publication Year :
- 2006
-
Abstract
- Objective: To estimate the rate of acute and recent HIV infections and the prevalence of primary antiretroviral resistance.<br />Design, Setting, and Subjects: A consecutive sample of individuals presenting for HIV testing at the San Francisco municipal sexually transmitted diseased (STD) clinic in 2004 (n = 3789).<br />Main Outcome Measures: HIV antibody-positive specimens were screened by BED IgG capture enzyme immunoassay to identify recent infections. HIV antibody-negative specimens were screened by nucleic acid amplification testing (NAAT) to detect acute infections. Newly detected infections were genotyped to detect primary antiretroviral resistance.<br />Results: There were 11 acute and 44 recent HIV infections among the total 136 newly detected cases. NAAT increased case identification by 8.08% over standard antibody testing. Acute HIV infections were associated with having a known HIV-positive partner, and a history of hepatitis B, syphilis, and chlamydia. The prevalence of primary antiretroviral resistance was 13.2%, with drug-resistant mutations detected in 17 of 129 cases genotyped. Mutations conferring resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI) were present in 11 of 17 cases.<br />Conclusion: The integration of HIV nucleic acid amplification, recent infection, and antiretroviral resistance testing enhanced HIV/STD surveillance. The high proportion of NNRTI mutations detected suggests they may be more common in source partners or more fit for transmission than other forms of drug-resistant HIV-1. Primary antiretroviral resistance monitoring in STD clinic patients may guide the selection of treatment and post-exposure prophylaxis regimens active against viruses being transmitted in the community, and provide health departments with surveillance data in a sentinel population at risk of HIV transmission.
- Subjects :
- Acute Disease
Adult
Aged
Algorithms
Drug Resistance, Viral genetics
Female
Genotype
HIV Infections drug therapy
HIV Infections epidemiology
Homosexuality, Male statistics & numerical data
Humans
Incidence
Male
Middle Aged
Mutation genetics
San Francisco epidemiology
HIV Infections diagnosis
Reverse Transcriptase Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0269-9370
- Volume :
- 20
- Issue :
- 17
- Database :
- MEDLINE
- Journal :
- AIDS (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 17086059
- Full Text :
- https://doi.org/10.1097/01.aids.0000252059.85236.af