Drug resistance mutations were identified using the Stanford HIV Drug Resistance Database. We obtained sequence data from a group of 316 HIV-positive individuals in the San Mateo AIDS Program over a 14-year period and integrated epidemiologic, phylogenetic, and network approaches to characterize transmission clusters, risk factors and drug resistance. The virologic and clinical consequences of treatment within these multiple ethnic and behavioral groups are poorly understood, highlighting the need for efficient surveillance strategies that are able to elucidate transmission networks and drug resistance patterns. Limited access to care has led historically to delayed clinical presentation, higher rates of opportunistic infections, and an increased prevalence of antiretroviral drug resistance. The HIV epidemic in San Mateo County is sustained by multiple overlapping risk groups and is an important hub for HIV transmission in northern California. 8Department of Global Health, University of Washington, Seattle, WA, United States.7San Mateo Medical Center, San Mateo, CA, United States.6Institute for Genomics and Evolutionary Medicine, Temple University, Philadelphia, PA, United States.5Division of Hematology, Stanford University School of Medicine, Stanford, CA, United States.4School of Laboratory Medicine and Medical Science, Department of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.3KwaZulu-Natal Research Innovation and Sequencing Platform, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
1Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States.Kosakovsky Pond 6, Vivian Levy 1,7, Dennis Israelski 1,7, Tulio de Oliveira 3,4,8 and David Katzenstein 1 Dalai 1,2*†, Dennis Maletich Junqueira 3,4*†, Eduan Wilkinson 3,4, Renee Mehra 5, Sergei L.
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