Low prevalence of transmitted K65R and other tenofovir resistance mutations across different HIV‐1 subtypes: implications for pre‐exposure prophylaxis

• DOI: 10.7448/ias.15.2.17701
• Publication Date: 2012-10-16T10:59:46Z
• Authors: Philip A Chan; Austin Huang; Rami Kantor
• Keywords: Tenofovir; Pre-exposure prophylaxis; HIV drug resistance

Introduction Tenofovir‐containing regimens have demonstrated potential efficacy as pre‐exposure prophylaxis (PrEP) in preventing HIV‐1 infection. Transmitted drug resistance mutations associated with tenofovir, specifically the reverse transcriptase (RT) mutation K65R, may impact effectiveness of PrEP. The worldwide prevalence transmitted tenofovir different subtypes is unknown. Methods Sequences from treatment‐naïve studies and databases were aggregated analyzed by Stanford Database tools per International AIDS Society (IAS‐USA) criteria. RT sequences collected GenBank, HIV Sequence Los Alamos Database. underwent rigorous quality control measures. Tenofovir‐associated included K70E, T69‐insertion ≥3 thymidine analogue (TAMs), inclusive M41L or L210W. Results A total 19,823 evaluated across diverse (Subtype A: 1549 sequences, B: 9783, C: 3198, D: 483, F: 372, G: 594, H: 41, J: 69, K: 239, CRF01_AE: 1797 CRF02_AG: 1698). Overall, was 0.4% (n=77/19,823, 95% confidence interval CI: 0.3 to 0.5). K65R found 20 (0.1%, 0.06 0.15). Differences between not statistically significant. K70E TAMs 0.015% (95% 0.004 0.04) 0.27% 0.2 0.4) respectively. Conclusions Prevalence other recombinants low, suggesting minimal effect on tenofovir‐containing PrEP regimens.