Evolution of HIV-1 surveillance drug resistance mutations over ten years in New South Wales, Australia

Abstract New South Wales (NSW) has the greatest burden of HIV in Australia, with 2012 and 2013 recording the highest rates of new diagnoses in twenty years. Concurrently, there has been significant changes in antiretorviral treatments and testing paradigms. We compiled a statewide resistance database to characterize changes in HIV-1 resistance mutations over time. Genotypic antiretroviral resistance testing (GART) was performed on request at three reference laboratories using commercial and in house methods. 7629 HIV-1 polymerase sequences obtained from GART from 2004-2013 were retrospectively collated, reformatted, de-identified and analysed using Stanford HIVdb program 7.0 and the 2009 WHO Surveillance Drug Resistance Mutations (SDRM). Analyses were performed on subgroups of known treatment naives, treatment experienced and seroconverters. There has been a decrease in overall rates of prevalent drug resistance mutations from 57.8% in 2004 to 21% in 2013. Dual and triple class resistance mutations have d...