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Increase in transmitted resistance to non-nucleoside reverse transcriptase inhibitors among newly diagnosed HIV-1 infections in Europe

  • Autori: Frentz, D.; Van de Vijver, D.; Abecasis, A.; Albert, J.; Hamouda, O.; Jørgensen, L.; Ku¨cherer, C.; Struck, D.; Schmit, J.; Vercauteren, J.; A˚sjo¨, B.; Balotta, C.; Beshkov, D.; Camacho, R.; Clotet, B.; Coughlan, S.; Griskevicius, A.; Grossman, Z.; Horban, A.; Kolupajeva, T.; Korn, K.; Kostrikis, L.; Liitsola, K.; Linka, M.; Nielsen, C.; Otelea, D.; Paraskevis, D.; Paredes, R.; Poljak, M.; Puchhammer Sto¨ckl, E.; So¨nnerborg, A.; Stanekova, D.; Stanojevic, M.; Van Wijngaerden, E.; Wensing, A.; Boucher, C.; Vitale, F.; Tramuto, F.
  • Anno di pubblicazione: 2014
  • Tipologia: Articolo in rivista (Articolo in rivista)
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Background: One out of ten newly diagnosed patients in Europe was infected with a virus carrying a drug resistant mutation. We analysed the patterns over time for transmitted drug resistance mutations (TDRM) using data from the European Spread program.Methods: Clinical, epidemiological and virological data from 4317 patients newly diagnosed with HIV-1 infection between 2002 and 2007 were analysed. Patients were enrolled using a pre-defined sampling strategy.Results: The overall prevalence of TDRM in this period was 8.9% (95% CI: 8.1-9.8). Interestingly, significant changes over time in TDRM caused by the different drug classes were found. Whereas nucleoside resistance mutations remained constant at 5%, a significant decline in protease inhibitors resistance mutations was observed, from 3.9% in 2002 to 1.6% in 2007 (p = 0.001). In contrast, resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) doubled from 2.0% in 2002 to 4.1% in 2007 (p = 0.004) with 58% of viral strains carrying a K103N mutation. Phylogenetic analysis showed that these temporal changes could not be explained by large clusters of TDRM.Conclusion: During the years 2002 to 2007 transmitted resistance to NNRTI has doubled to 4% in Europe. The frequent use of NNRTI in first-line regimens and the clinical impact of NNRTI mutations warrants continued monitoring.