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首页> 外文期刊>AIDS Research and Human Retroviruses >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.
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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.

机译：博茨瓦纳的艾滋病毒传播耐药性流行情况：从作为例行产前保健的妇女中进行的HIVDR阈值调查中吸取的经验教训作为2007年全国哨兵调查的一部分。

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摘要

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.
机译：在资源有限的国家中，快速发展的抗逆转录病毒治疗（ART）计划的成功对传播耐药性（TDR）的出现和传播构成了重大威胁。世界卫生组织建议使用艾滋病毒抗药性阈值调查（HIVDR-TS）作为监测这些环境中TDR是否存在的负担得起的手段。我们报告了我们在博茨瓦纳的2007 HIVDR-TS的经验和成果，该国是非洲存在时间最长的国家公共ART计划之一。作为2007年产前博茨瓦纳前哨调查的一部分，在两个最大的国家地点进行了HIVDR-TS和HIV-1发病率测试。 HIVDR-TS在一个部位未显示出明显的耐药突变（TDR小于5％）。但是，由于样本量少，无法确定第二个站点的TDR患病率。 HIVDR-TS资格标准与基于实验室的方法学（即BED-CEIA和LS-EIA）之间在确定最近感染HIV-1的成年人之间的协议很差。博茨瓦纳公共ART计划建立五年后，TDR的患病率仍然很低。与博茨瓦纳一样，HIVDR-TS方法在低密度人群中也有局限性，在博茨瓦纳，大多数产前部位太小而无法招募足够数量的患者。此外，HIVDR-TS的入选标准（年龄<25岁且均等（首次怀孕））在确定博茨瓦纳最近的HIV-1感染方面表现不佳。在博茨瓦纳和类似的地理环境中，应考虑采用另一种采样策略来监测HIVDR。

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