TY - JOUR
T1 - Transmission of drug-resistant HIV-1 in Europe remains limited to single classes
AU - Tramuto, Fabio
AU - Vitale, Francesco
AU - Kücherer, Claudia
AU - Nielsen, Claus
AU - Vercauteren, Jurgen
AU - Loke, Wei C.
AU - Struck, Daniel
AU - Vandamme, Anne-Mieke
AU - Boucher, Charles A.B.
AU - Poggensee, Gabrielle
AU - Poggensee, Gabrielle
AU - Nielsen, Claus
AU - Schuurman, Rob
AU - Van De Vijver, David A.
AU - Riva, Chiara
AU - Stanojevic, Maja
AU - Horban, Andrzej
AU - Camacho, Ricardo
AU - Stanojevic, Maja
AU - Wensing, Annemarie M.J.
AU - Paraskevis, Dimitris
AU - Coughlan, Suzie
AU - Puchhammer-Stöckl, Elisabeth
AU - Balotta, Claudia
AU - Sonnerborg, Anders
AU - Grossman, Zehava
AU - Åsjö, Birgitta
AU - Salminen, Mika
AU - Schmit, Jean-Claude
AU - Ruiz, Lidia
AU - Albert, Jan
AU - Camacho, Ricardo
PY - 2008
Y1 - 2008
N2 - BACKGROUND: The spread of drug-resistant HIV-1 might compromise the future success of current first-line regimens. OBJECTIVE: To analyse the extent and impact of transmission of drug-resistant HIV-1 variants in Europe. DESIGN AND METHODS: The European prospective programme (SPREAD) collected demographic, clinical and virological data from 1245 HIV-1-infected individuals in 17 countries diagnosed in 2002-2003. The potential impact of transmitted drug resistance mutations (TDRMs) on therapy response was determined by using genotypic interpretation algorithms. RESULTS: The overall prevalence of viruses with drug-resistance mutations was 9.1% [96/1050; 95% confidence interval: 7.5-11.1]. The majority (71%) harboured only a single amino acid substitution with limited effect on predicted drug susceptibility. Mutations associated with resistance to nucleoside reverse transcriptase inhibitors were observed most frequently [57/1050 (5.4%)], followed by mutations related to protease inhibitors [32/1050 (3.0%)] and mutations related to non-nucleoside reverse transcriptase inhibitors (NNRTIs) [27/1050 (2.6%)].In some cases, however, resistance was quite extensive. Four individuals were infected with viruses with reduced susceptibility to all nucleoside reverse transcriptase inhibitors, 3 to all protease inhibitors and 20 to both NNRTIs. Remarkably, in one individual, the resistance pattern was so extensive that none of the available current antiretroviral drugs was predicted to be fully active. CONCLUSION: The prevalence of TDRM-HIV is quite prominent (9.1%) but did not increase in comparison with a large retrospective European study. Particularly the presence of single NNRTI mutations may impact the efficacy of the first-line regimens. Continuous prospective monitoring remains indicated to explore the patterns and factors contributing to the transmission of TDRMs as well as the potential clinical consequences. © 2008 Lippincott Williams & Wilkins, Inc.
AB - BACKGROUND: The spread of drug-resistant HIV-1 might compromise the future success of current first-line regimens. OBJECTIVE: To analyse the extent and impact of transmission of drug-resistant HIV-1 variants in Europe. DESIGN AND METHODS: The European prospective programme (SPREAD) collected demographic, clinical and virological data from 1245 HIV-1-infected individuals in 17 countries diagnosed in 2002-2003. The potential impact of transmitted drug resistance mutations (TDRMs) on therapy response was determined by using genotypic interpretation algorithms. RESULTS: The overall prevalence of viruses with drug-resistance mutations was 9.1% [96/1050; 95% confidence interval: 7.5-11.1]. The majority (71%) harboured only a single amino acid substitution with limited effect on predicted drug susceptibility. Mutations associated with resistance to nucleoside reverse transcriptase inhibitors were observed most frequently [57/1050 (5.4%)], followed by mutations related to protease inhibitors [32/1050 (3.0%)] and mutations related to non-nucleoside reverse transcriptase inhibitors (NNRTIs) [27/1050 (2.6%)].In some cases, however, resistance was quite extensive. Four individuals were infected with viruses with reduced susceptibility to all nucleoside reverse transcriptase inhibitors, 3 to all protease inhibitors and 20 to both NNRTIs. Remarkably, in one individual, the resistance pattern was so extensive that none of the available current antiretroviral drugs was predicted to be fully active. CONCLUSION: The prevalence of TDRM-HIV is quite prominent (9.1%) but did not increase in comparison with a large retrospective European study. Particularly the presence of single NNRTI mutations may impact the efficacy of the first-line regimens. Continuous prospective monitoring remains indicated to explore the patterns and factors contributing to the transmission of TDRMs as well as the potential clinical consequences. © 2008 Lippincott Williams & Wilkins, Inc.
KW - Europe; HIV-1; Resistance; Transmission; Adult; Chi-Square Distribution; Disease Transmission
KW - Infectious; Europe; Female; Genes
KW - Viral; Genotype; HIV Infections; HIV Protease Inhibitors; HIV-1; Humans; Israel; Logistic Models; Male; Middle Aged; Prevalence; Risk; Drug Resistance
KW - Viral; Mutation; Reverse Transcriptase Inhibitors; Immunology and Allergy; Immunology
KW - Europe; HIV-1; Resistance; Transmission; Adult; Chi-Square Distribution; Disease Transmission
KW - Infectious; Europe; Female; Genes
KW - Viral; Genotype; HIV Infections; HIV Protease Inhibitors; HIV-1; Humans; Israel; Logistic Models; Male; Middle Aged; Prevalence; Risk; Drug Resistance
KW - Viral; Mutation; Reverse Transcriptase Inhibitors; Immunology and Allergy; Immunology
UR - http://hdl.handle.net/10447/192760
M3 - Article
SN - 0269-9370
VL - 22
SP - 625
EP - 635
JO - AIDS
JF - AIDS
ER -