Sasisopin KiertiburanakulRomanee ChaiwarithSunee SirivichayakulRossana DitangcoAwachana JiamsakulPatrick C.K. LiPacharee KantipongChristopher LeeWinai RatanasuwanAdeeba KamarulzamanAnnette H. SohnSomnuek SungkanuparphMahidol UniversityChiang Mai UniversityChulalongkorn UniversityGokilaUniversity of New South Wales (UNSW) AustraliaQueen Elizabeth Hospital Hong KongChiang Rai Regional HospitalHospital Sungai BulohUniversity of Malaya Medical CentreamfAR - The Foundation for AIDS Research2018-10-192018-10-192013-06-27PLoS ONE. Vol.8, No.6 (2013)193262032-s2.0-84879513245https://repository.li.mahidol.ac.th/handle/20.500.14594/31012Background:The emergence and transmission of HIV-1 drug resistance (HIVDR) has raised concerns after rapid global antiretroviral therapy (ART) scale-up. There are limited data on the epidemiology of primary HIVDR in resource-limited settings in Asia. We aimed to determine the prevalence and compare the distribution of HIVDR in a cohort of ART-naïve Asian patients with recent and chronic HIV-1 infection.Methods:Multicenter prospective study was conducted in ART-naïve patients between 2007 and 2010. Resistance-associated mutations (RAMs) were assessed using the World Health Organization 2009 list for surveillance of primary HIVDR.Results:A total of 458 patients with recent and 1,340 patients with chronic HIV-1 infection were included in the analysis. The overall prevalence of primary HIVDR was 4.6%. Recently infected patients had a higher prevalence of primary HIVDR (6.1% vs. 4.0%, p = 0.065) and frequencies of RAMs to protease inhibitors (PIs; 3.9% vs. 1.0%, p<0.001). Among those with recent infection, the most common RAMs to nucleoside reverse transcriptase inhibitors (NRTIs) were M184I/V and T215D/E/F/I/S/Y (1.1%), to non-NRTIs was Y181C (1.3%), and to PIs was M46I (1.5%). Of patients with chronic infection, T215D/E/F/I/S/Y (0.8%; NRTI), Y181C (0.5%; non-NRTI), and M46I (0.4%; PI) were the most common RAMs. K70R (p = 0.016) and M46I (p = 0.026) were found more frequently among recently infected patients. In multivariate logistic regression analysis in patients with chronic infection, heterosexual contact as a risk factor for HIV-1 infection was less likely to be associated with primary HIVDR compared to other risk categories (odds ratio 0.34, 95% confidence interval 0.20-0.59, p<0.001).Conclusions:The prevalence of primary HIVDR was higher among patients with recent than chronic HIV-1 infection in our cohort, but of borderline statistical significance. Chronically infected patients with non-heterosexual risks for HIV were more likely to have primary HIVDR. © 2013 Kiertiburanakul et al.Mahidol UniversityAgricultural and Biological SciencesBiochemistry, Genetics and Molecular BiologyArticleSCOPUS10.1371/journal.pone.0062057