HIV-1 Strain and Primary Drug Resistance in Canada

Surveillance Report to March 31, 2005

PDF Version

August 2006

This report is available:

© Her Majesty the Queen in Right of Canada, represented by the Minister of Health, 2006. Catalogue No. HP37-6/2005 ISBN 0-662-49420-2

Surveillance and Risk Assessment Division
National HIV and Retrovirology Laboratories
Centre for Infectious Disease Prevention and Control
Public Health Agency of Canada

Acknowledgements: We acknowledge the provincial/territorial HIV/AIDS coordinators, laboratories, health care providers, and reporting physicians for providing the data required to publish this report. Please refer to. Appendix 7 and Section III for the list of these contributors.

We also thank Scientific Publication and Multimedia services for its contribution in editing and producing the report.

N.B. This document must be cited as the source for any information extracted and used from it.

Suggested citation: Public Health Agency of Canada. HIV-1 Strain and Primary Drug Resistance in Canada: Surveillance Report to March 31, 2005. Surveillance and Risk Assessment Division, Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada, 2006.

Information to the readers of HIV-1 Strain and Primary Drug Resistance in Canada

On behalf of the Surveillance and Risk Assessment Division and the National HIV and Retrovirology Laboratories, we are pleased to provide you with the HIV-1 Strain and Primary Drug Resistance in Canada: Surveillance Report to March 31, 2005. This report is part of an annual series, providing a review of the genetic diversity of HIV in Canada.

The major findings of the surveillance data are outlined in the section entitled Results at a Glance. This is followed by a series of tables summarizing the HIV-1 strain and primary drug resistance data. Each table provides specific explanatory details, as appropriate. A further description of HIV-1 strain and primary drug resistance in Canada is available in the HIV/AIDS Epi Updates reports available on our web site at http://www.phac-aspc.gc.ca/hast-vsmt/public_e.html#sur. Technical notes, references, and data sources are available in the Appendices.

The first section describes HIV-1 subtypes in Canada as determined by the Canadian HIV Strain and Drug Resistance Surveillance Program and outlines the results from other key studies conducted in Canada, the United States, and Western Europe. The second section describes HIV-1 primary drug resistance in Canada, as determined by the Canadian HIV Strain and Drug Resistance Surveillance Program, and outlines results from other key studies in countries where highly active antiretroviral therapy is widely available. The third section describes data that have been gathered through the Québec program for HIV drug resistance testing.

The Field Surveillance Officers are responsible for coordinating data collection and submission to the HIV Drug Resistance and Field Surveillance Section and the HIV/AIDS Surveillance. The HIV Drug Resistance and Field Surveillance Section is responsible for managing and analyzing data, as well as writing and coordinating the publication of this report. The National Laboratory for HIV Genetics conducts the strain and primary drug resistance genotyping, and phylogenetic analysis. The National Laboratory for HIV Reference Services determines the estimated time of infection, using a combination of two commercially available kits: the bioMérieux Vironostika HIV-1-LS ^TM and the Abbott 3A11-LS ^TM assays. This laboratory also serves as a sentinel arm in monitoring the presence of unusual strains of HIV in Canada.

The publication of this report would not be possible without the involvement of the provinces and territories participating in our national HIV strain and drug resistance surveillance program. Key colleagues across Canada provided scientific input and feedback on the program content including helping to develop the infrastructure, information-flow and specimentransfer processes on which this national surveillance program is based. Their ongoing collaboration and contribution to this surveillance program is gratefully acknowledged in Appendix 7. Thanks also to our colleagues in Québec who shared data from the Québec program for drug resistance testing for inclusion in Section III of this report.

This is the fourth report on HIV strain and primary drug resistance surveillance in Canada. We will be working toward improving this report to reflect changes in the surveillance of HIV strain and primary drug resistance.
We welcome and appreciate your comments and suggestions.

Yours sincerely,

Dr. Gayatri Jayaraman	Dr. James Brooks
Dr. Chris Archibald	Dr. Paul Sandstrom

HIV-1 Strain and Primary Drug Resistance in Canada

Table of Contents

Results at a Glance
Tables
Section I
HIV-1 Subtypes ( 1984 - March 31, 2005)
Table 1	Number and percentage distribution of HIV-1 subtypes among newly diagnosed, treatment-naive individuals (1984 - March 31, 2005)
Table 2	Number and percentage distribution of HIV-1 subtypes by year of diagnosis with HIV-1 infection
Table 3	Number and percentage distribution of HIV-1 subtypes by province
Table 4	Number and percentage distribution of HIV-1 subtypes by age at diagnosis with HIV infection.
Table 5	Number and percentage distribution of HIV-1 subtypes by gender
Table 6	Number and percentage distribution of HIV-1 subtypes by exposure category
Table 7	Number and percentage distribution of HIV-1 subtypes by ethnicity
Table 8	Number and percentage distribution of HIV-1 subtypes by recently acquired vs. established HIV-1 infection
Table 9	Number and percentage distribution of HIV-1 subtypes by primary drug resistance
Section II
HIV-1 Primary Drug Resistance (1996 - March 31, 2005)
Table 10	Number and percentage distribution of primary drug resistance among newly diagnosed, treatment-naive individuals (1996 - March 31, 2005)
Table 11	Mutations in reverse transcriptase and major mutations in protease
Table 12	Number and percentage distribution of primary drug resistance by year of diagnosis
Table 13	Number and percentage distribution of primary drug resistance by province
Table 14	Number and percentage distribution of primary drug resistance by age at diagnosis with HIV infection
Table 15	Number and percentage distribution of primary drug resistance by gender
Table 16	Number and percentage of primary drug resistance by exposure category
Table 17	Number and percentage of primary drug resistance by ethnicity
Table 18	Number and percentage of primary drug resistance by HIV-1 subtype
Table 19	Number and percentage of primary drug resistance by recently acquired vs. established HIV-1 infection
Table 20	Summary of key studies on drug resistance among newly diagnosed, treatment-naive individuals in Canada
Table 21	Summary of key studies on drug resistance among newly diagnosed, treatment-naive individuals in the United States and in Western Europe

Section III

Québec program for HIV drug resistance testing

Appendices

• Appendix 1 - Overview of the Canadian HIV Strain and Drug Resistance Surveillance Program
• Appendix 2  - Methodology
• Appendix 3 - Technical Notes
• Appendix 4 - Data Limitations
• Appendix 5 - Glossary of Terms
• Appendix 6 -  List of mutations used for this report
• Appendix 7 - Data Sources