Last data update: May 13, 2024. (Total: 46773 publications since 2009)
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Query Trace: Lehotzky EA[original query] |
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Prevalence of transmitted HIV drug resistance in Botswana: Lessons learned from the HIVDR-Threshold Survey conducted among women presenting for routine antenatal care as part of the 2007 National Sentinel Survey
Bussmann H , de la Hoz Gomez F , Roels TH , Wester CW , Bodika SM , Moyo S , Taffa N , Anderson MG , Mine M , Bile EC , Yang C , Mphoyakgosi K , Lehotzky EA , Mlotshwa B , Mmelesi M , Seipone K , Makhema MJ , Marlink RG , Novitsky V , Essex M . AIDS Res Hum Retroviruses 2011 27 (4) 365-72 The emergence and spread of transmitted drug resistance (TDR) poses a major threat to the success of the rapidly expanding antiretroviral treatment (ART) programs in resource-limited countries. The World Health Organization recommends the use of the HIV Drug Resistance Threshold Survey (HIVDR-TS) as an affordable means to monitor the presence of TDR in these settings. We report our experiences and results of the 2007 HIVDR-TS in Botswana, a country with one of the longest-existing national public ART programs in Africa. The HIVDR-TS and HIV-1 incidence testing were performed in the two largest national sites as part of the 2007 antenatal Botswana Sentinel Survey. The HIVDR-TS showed no significant drug resistance mutations (TDR less than 5%) in one site. TDR prevalence, however, could not be ascertained at the second site due to low sample size. The agreement between HIVDR-TS eligibility criteria and laboratory-based methodologies (i.e., BED-CEIA and LS-EIA) in identifying recently HIV-1 infected adults was poor. Five years following the establishment of Botswana's public ART program, the prevalence of TDR remains low. The HIVDR-TS methodology has limitations for low-density populations as in Botswana, where the majority of antenatal sites are too small to recruit sufficient numbers of patients. In addition, the eligibility criteria (age <25 years and parity (first pregnancy)) of the HIVDR-TS performed poorly in identifying recent HIV-1 infections in Botswana. An alternative sampling strategy should be considered for the surveillance of HIVDR in Botswana and similar geographic settings. |
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