Low rates of transmitted drug resistance among newly identified HIV-1 seroconverters in Rural Rakai, Uganda

Steven J. Reynolds, Victor Ssempijja, Ronald Galiwango, Anthony Ndyanabo, Gertrude Nakigozi, Fred Lyagoba, Jamirah Nazziwa, Andrew Redd, Susanna L. Lamers, Ron Gray, Maria Wawer, David Serwadda, Thomas C. Quinn

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


We investigated the rate of transmitted drug resistance (TDR) among HIV-1 seroconverters identified from the Rakai Community Cohort Study (RCCS) survey, a population-based cohort in Rakai District, Uganda. Participants aged 15-49 are interviewed at study visits approximately every 12-18 months and provided a serological sample. Antiretroviral therapy (ART) has been provided free of charge since 2004. RCCS participants with documented negative HIV-1 serology between January 2011 and August 2012 and confirmed seroconversion between November 2012 and October 2013 were included in this analysis. Serum was genotyped for HIV drug resistance mutations in reverse transcriptase and protease genes. Mutations were classified according to the 2009 World Health Organization surveillance of transmitted HIV-1 drug resistance update. Seventy-five (75) seroconverters were identified and genotyped. The mean age was 28 years (range 18-49) and the majority were male, n = 44 (58%). The HIV-1 subtype frequencies were A = 19 (25%), D = 44 (59%), C = 4 (5%), A/D recombinant = 5 (7%), and C/D recombinant = 3 (4%). The majority (72/75, 96%) of individuals were infected with wild-type virus with no evidence of TDR. Two individuals had a single non-nucleoside reverse transcriptase inhibitor mutation each, K101E and K103N, and one had a single protease inhibitor mutation, M46I. No mutations were identified involving nucleoside reverse transcriptase inhibitors. In conclusion, almost 10 years after the introduction of ART in rural Uganda, rates of TDR remain low. Ongoing surveillance for TDR remains an important public health priority and should be conducted among known seroconverters to estimate TDR.

Original languageEnglish (US)
Pages (from-to)448-451
Number of pages4
JournalAIDS research and human retroviruses
Issue number5
StatePublished - May 2017


  • Antiretroviral therapy
  • Drug resistance
  • HIV

ASJC Scopus subject areas

  • Immunology
  • Virology
  • Infectious Diseases


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