A Review of the Extent of HIV Drug Resistance in Vietnam

Abstract

Background: In 2005, free antiretroviral therapy (ART) was rolled-out as a national program in Viet Nam. The estimated population of people living with HIV reached 254,000 in 2010 and this leads to increasing demand of ART in the near future. By 2009, ART coverage reached 53.7% for adults and adolescents, and 49.7% for children. This study aims to describe the prevalence of HIV acquired drug resistance (ADR) among people receiving ART and prevalence of transmitted drug resistance (TDR) among recently HIV-infected persons in Vietnam, and their associated ART coverage, antiretroviral treatment adherence and risk behaviors. Methods: We performed a comprehensive review of published English literature containing relevant epidemiological and behavioral indicators through internet searches. Results: Twenty-one relevant publications were included in this review. TDR prevalence among people recently infected with HIV increased from below 5% in 2006 to a higher level of 5-15% during 2007-2008 in urban Vietnam, whereas TDR prevalence among chronic antiretroviral-naive HIV-infected adults stabilized between 6-8% across the country. About half of all adults and children with clinical or immunological criteria of therapeutic failure had evidence of developing resistance to antiretroviral drugs. Non-adherence among adults on ART ranged between 25-32% and the level of viral suppression (< 1,000 copies/ml) fluctuated from 68% to more than 83% at 12 month after initiating ART. However, relevant data concerning children were mostly absent. Conclusion: Increasing trend of transmission of HIV drug resistance was observed in urban Vietnam, suggesting an urgency of the establishment of regular surveillance for TDR. Viral load testing and availability of second or third line ART are recommended for the early diagnosis of drug resistance and prevention of its accumulation and transmission.