Public Availability of HIV-1 Drug Resistance Sequence and Treatment Data: A Systematic Review

Abstract

Background: HIV-1 pol sequences from antiretroviral therapy (ART)-naive and -experienced people living with HIV are fundamental to understand the genetic correlates and epidemiology of HIV drug resistance (HIVDR). We aimed to assess the public availability of HIV-1 pol sequences and ART histories of the persons from whom the sequenced viruses were obtained. Methods: We performed a systematic review of PubMed and GenBank for HIVDR studies published between 2010 and 2019 that reported HIV-1 pol sequences. Each study was characterized by year, geographic region, journal, type of ART, and availability of pol sequences and linked ART histories. Findings: 934 studies met inclusion criteria including 461 of ART-naive adults, 407 of ART-experienced adults, and 66 ART-naive and -experienced children. Seventy-two (7·7%) studies were registered clinical trials. Sequences were available for 317 (68·8%) studies of ART-naive persons, 190 (46·7%) studies of ART-experienced persons, and 45 (68·2%) studies of children. Among ART-experienced persons, sequences plus linked ART histories were available for 82 (20·1%) studies. Sequences were available for 21 (29·2%) of the clinical trials. Among journals publishing the most studies, the proportion with available sequences ranged from 8·3% to 86·9%. Interpretation: HIV-1 pol sequences were available for approximately one-half of studies while sequences plus linked ART histories were available for 20% of studies. Strengthened implementation of data sharing policies are needed to increase the number of studies with available HIVDR data to better support the enterprise of global ART in the face of emerging HIVDR. Funding: U.S. NIAID / NIH. Declaration of Interests: No competing financial interests exist.