TEMPORAL TRENDS AND TRANSMISSION DYNAMICS OF PRE-TREATMENT HIV-1 DRUG RESISTANCE WITHIN AND BETWEEN RISK GROUPS IN KENYA, 1986-2020

• DOI: 10.1101/2023.03.21.23287487
• Publication Date: 2023-03-23T02:30:10Z
• Authors: George M. Nduva; Frederick Otieno; Joshua Kimani; Yiakon Sein; Dawit A. Arimide; Lyle R. McKinnon; Francois Cholette; Morris K. Lawrence; Maxwell Majiwa; Moses Masika; Gaudensia Mutua; Omu Anzala; Susan M. Graham; Larry Gelmon; Matt A. Price; Adrian D. Smith; Robert C. Bailey; Patrik Medstrand; Eduard J. Sanders; Joakim Esbjörnsson; Amin S. Hassan
• Keywords: HIV drug resistance

ABSTRACT Background Evidence on the distribution of pre-treatment HIV-1 drug resistance (HIVDR) by risk groups is limited in Africa. We assessed prevalence, trends, and transmission dynamics HIVDR within-and-between men who have sex with (MSM), people inject drugs (PWID), female workers (FSW), heterosexuals (HET), children infected perinatally Kenya. Methods partial pol sequences from antiretroviral-naïve samples collected between 1986-2020 were used. Pre-treatment RTI, PI INSTI mutations using Stanford database. Phylogenetics methods used to determine date clusters. Results Of 3567 analysed, 550 (15.4%, 95% CI: 14.2-16.6) had at least one mutation, which was most prevalent amongst (41.3%), followed PWID (31.0%), MSM (19.9%), FSW (15.1%) HET (13.9%). No detected. Among HET, increased 6.6% 1986-2005 20.2% 2011-2015 but dropped 6.5% 2016-2020. Overall, 22 clusters shared identified. The largest a K103N mutation cluster involving 16 sampled 2010-2017, an estimated tMRCA 2005 (HPD, 2000-2008). This lineage growth rate=0.1/year R 0 =1.1, indicating propagation over 12 years among ART-naïve Conclusions Compared key populations higher levels HIVDR. Introduction INSTIs after 2016 may reversed increase RTI Continued surveillance HIVDR, particular focus populations, warranted inform treatment strategies Summary heterosexual population, (HIVDR). Propagation risk-group exclusive. integrase inhibitors abrogated reverse transcriptase heterosexual, not populations.