National Prevalence of Transmitted HIV Drug Resistance
in Swaziland in 2011
R. Suzanne Beard, Ph.D.
Abstract/poster: TUPDC0103
Background Assessed the national level of transmitted drug
resistance (TDR) in recently HIV-infected adults (18-49 yrs.) using samples collected from seroconverters and acutely HIV-infected persons enrolled between 2010-2011 in the Swaziland HIV Incidence Measurement Survey (SHIMS)
18,172 adults completed household-based counseling and rapid HIV testing 13 seronegative, NAT positive (acute) 11,232 HIV-negative individuals had repeat HIV testing
six months later, 145 seroconverted (SC)
151 out of 158 HIV-positive samples were available for HIVDR analysis
Abstract/poster: TUPDC0103
Genotyping was performed with 3 assays: sequencing based (in-house), multiplex allele-specific (MAS), and allele-specific real-time PCR (AS-PCR)
detection limits of minor mutations of 20%, 1.6-12.5% and 0.2-1.7% respectively
TDR mutations were determined by Calibrated Population Resistance tool using the 2009 WHO DR mutation listAbstract/poster: TUPDC0103
Resistance Profile by Assay for Patients With TDR
Specimen # category
In-house Result
MAS Result
AS-PCR Result
20* SC K103N21 SC V106A V106AV31 SC Y181C33 SC Y181C
48 SC M46I+
72 SC V106M85 SC Y181C101 SC V106M103 SC V106M, Y181C122 SC Y181C Y181C Y181C141 acute Y181C148 acute K103N K103N K103N, Y181C151 acute Y181C148 acute K65R
4 3 13NNRTI
2.13%NNRTI
2.13% 7.91%* positive by in-house but was not successfully sequenced
designed to detect any PI mutations
Total Number of Major DR Mutations
+ the MAS-DR is not designed to detect this PI mutation and AS-PCR is not
Prevelence of TDR
Center for Global Health
Division of Global HIV/AIDS
Conclusions These findings provide the first estimate of the
national prevalence of TDR, using samples from a nationally representative cohort of HIV seroconverters and acutely HIV-infected individuals
Using WHO definitions, the TDR level in Swaziland is: low (<5%) based on the sequencing-based in-
house or more sensitive MAS assay moderate (5-15%) based on the ultrasensitive
AS-PCR Further work needs to be done to determine the
clinical significance of low-frequency DR mutations
Surveillance of TDR in recently HIV-1-infected populations can inform treatment programs on the efficacy of current ART regimens available
Abstract/poster: TUPDC0103