{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T02:16:45Z","timestamp":1784081805734,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Universal HIV testing and treatment (UTT) has individual and public health benefits. HPTN 071 (PopART), a community\u2010randomized trial in Zambia and South Africa, demonstrated that UTT decreased HIV incidence. This endpoint was assessed in a cohort of &gt;48,000 randomly selected adults in the study communities. We evaluated the impact of UTT on HIV drug resistance in this cohort and compared other resistance\u2010related outcomes in participants with recent versus non\u2010recent HIV infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two years after the start of HPTN 071 (2016\u20132017), 6259 participants were HIV positive and 1902 were viremic (viral load &gt;400\u00a0copies\/ml). HIV genotyping and antiretroviral (ARV) drug testing were performed for viremic participants in three groups: seroconverters (infected &lt;1\u00a0year), non\u2010seroconverters (infected &gt;1 year, random subset) and participants with unknown duration of infection (random subset). A two\u2010stage cluster\u2010based approach was used to assess the impact of the study intervention on drug resistance. Treatment failure was defined as being viremic with ARV drugs detected. Participants were classified as ARV na\u00efve based on self\u2010report and ARV drug testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Genotyping results were obtained for 758 participants (143 seroconverters; 534 non\u2010seroconverters; and 81 unknown duration of infection). The estimated prevalence of resistance in the study communities was 37% for all viremic persons and 11% for all HIV\u2010positive persons. There was no association between UTT and drug resistance. Resistance was detected in 14.0% of seroconverters and 40.8% of non\u2010seroconverters (non\u2010nucleoside reverse transcriptase inhibitor resistance: 14.0% and 39.9%; nucleoside\/nucleotide reverse transcriptase inhibitor resistance: 0.7% and 15.5%; protease inhibitor resistance: 0% and 1.9%; multi\u2010class resistance: 0.7% and 16.1%, respectively). ARV drugs were detected in 2\/139 (1.4%) of seroconverters and 94\/534 (17.6%) of non\u2010seroconverters tested. These participants were classified as failing ART; 88 (93.6%) of the non\u2010seroconverters failing ART had resistance. Mutations used for surveillance of transmitted drug resistance were detected in 10.5% of seroconverters and 15.1% of non\u2010seroconverters who were ARV naive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>UTT was not associated with an increase in drug resistance in this cohort. Higher rates of drug resistance and multi\u2010class resistance were observed in non\u2010seroconverters compared to seroconverters.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25941","type":"journal-article","created":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T10:05:41Z","timestamp":1656669941000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["HIV drug resistance in a community\u2010randomized trial of universal testing and treatment: HPTN 071 (PopART)"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3143-9000","authenticated-orcid":false,"given":"Jessica M.","family":"Fogel","sequence":"first","affiliation":[{"name":"Department of Pathology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan A.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Fred Hutchinson 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UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3211-6078","authenticated-orcid":false,"given":"Peter","family":"Bock","sequence":"additional","affiliation":[{"name":"Desmond Tutu TB Center, Department of Paediatrics and Child Health Stellenbosch University  Western Cape South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4108-2842","authenticated-orcid":false,"given":"Helen","family":"Ayles","sequence":"additional","affiliation":[{"name":"Zambart  Lusaka Zambia"},{"name":"Department of Clinical Research London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1676-7583","authenticated-orcid":false,"given":"Sarah","family":"Fidler","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease HIV Clinical Trials Unit, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1729-9892","authenticated-orcid":false,"given":"Richard","family":"Hayes","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0587-7480","authenticated-orcid":false,"given":"Deborah","family":"Donnell","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4587-791X","authenticated-orcid":false,"given":"Susan H.","family":"Eshleman","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the HPTN 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