National Prevalence of Transmitted HIV Drug Resistance in Swaziland in 2011 R. Suzanne Beard, Ph.D. Abstract/poster: TUPDC0103

Background  Assessed the national level of transmitted drug resistance (TDR) in recently HIV-infected adults (18-49 yrs.) using samples collected from seroconverters and acutely HIV- infected persons enrolled between in the Swaziland HIV Incidence Measurement Survey (SHIMS)  18,172 adults completed household-based counseling and rapid HIV testing  13 seronegative, NAT positive (acute)  11,232 HIV-negative individuals had repeat HIV testing six months later, 145 seroconverted (SC)  151 out of 158 HIV-positive samples were available for HIVDR analysis Abstract/poster: TUPDC0103

 Genotyping was performed with 3 assays: sequencing based (in-house), multiplex allele-specific (MAS), and allele-specific real-time PCR (AS-PCR)  detection limits of minor mutations of 20%, % and % respectively  TDR mutations were determined by Calibrated Population Resistance tool using the 2009 WHO DR mutation list Abstract/poster: TUPDC0103 Resistance Profile by Assay for Patients With TDR

Center for Global Health Division of Global HIV/AIDS Conclusions  These findings provide the first estimate of the national prevalence of TDR, using samples from a nationally representative cohort of HIV seroconverters and acutely HIV-infected individuals  Using WHO definitions, the TDR level in Swaziland is:  low (<5%) based on the sequencing-based in-house or more sensitive MAS assay  moderate (5-15%) based on the ultrasensitive AS-PCR  Further work needs to be done to determine the clinical significance of low-frequency DR mutations  Surveillance of TDR in recently HIV-1-infected populations can inform treatment programs on the efficacy of current ART regimens available Abstract/poster: TUPDC0103