High Prevalence of Pre-Treatment HIV Drug Resistance in Papua New Guinea: Findings from the First Nationally Representative Pre-Treatment HIV Drug Resistance Study

Abstract

Abstract Background: Determining the prevalence of pre-treatment HIV drug resistance (PDR) is important to assess the effectiveness of first-line therapies. To determine PDR prevalence in Papua New Guinea (PNG), we conducted a nationally representative survey.Methods: We used a two-stage cluster sampling method to recruit HIV treatment initiators with and without prior exposure to antiretroviral therapies (ART) in selected clinics. Dried blood spots were collected and tested for PDR.Results: A total of 315 sequences were available for analysis. The overall PDR prevalence rate was 18.4%. The prevalence of PDR to non-nucleoside analog reverse-transcriptase inhibitors (NNRTIs) was 17.8% and of PDR to nucleoside reverse transcriptase inhibitors (NRTIs) was 6.3%. The PDR prevalence rate among people reinitiating ART was 42.4%. Conclusions: PNG has a high PDR prevalence rate, especially to NNRTI-based first-line therapies. Our findings suggest that removing NNRTIs as part of first-line treatment is warranted and will lead to improving viral suppression rates in PNG.</jats:p