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Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe

LM. Hofstra, N. Sauvageot, J. Albert, I. Alexiev, F. Garcia, D. Struck, DA. Van de Vijver, B. Åsjö, D. Beshkov, S. Coughlan, D. Descamps, A. Griskevicius, O. Hamouda, A. Horban, M. Van Kasteren, T. Kolupajeva, LG. Kostrikis, K. Liitsola, M....

. 2016 ; 62 (5) : 655-63. [pub] 20151129

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc17000832

BACKGROUND: Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001. METHODS: Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)-infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0. RESULTS: The overall prevalence of TDR did not change significantly over time and was 8.3% (95% confidence interval, 7.2%-9.5%) in 2008-2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9%) and protease inhibitor mutations (2.0%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5% and 6.5% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones. CONCLUSIONS: Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected.

AP HP Groupe hospitalier Bichat Claude Bernard IAME INSERM UMR 1137 Université Paris Diderot Sorbonne Paris Cité Paris France

Complejo Hospitalario Universitario de Granada Instituto de Investigación IBS Granada

Department of Infectious Diseases National Institute for Health and Welfare Helsinki Finland

Department of Virology University Medical Center Utrecht The Netherlands

Erasmus MC University Medical Center Rotterdam The Netherlands

Faculty of Medicine Slovenian HIV AIDS Reference Centre University of Ljubljana Slovenia

Faculty of Medicine University of Belgrade Serbia

Hospital of Infectious Diseases Warsaw Poland

Infectiology Center of Latvia Riga

IrsiCaixa Foundation Badalona Spain

Karolinska Institute Solna Karolinska University Hospital Stockholm Sweden

Lithuanian AIDS Center Vilnius Lithuania

Luxembourg Institute of Health Luxembourg

Luxembourg Institute of Health Luxembourg Department of Virology University Medical Center Utrecht The Netherlands

Medical University Vienna Austria

National Center of Infectious and Parasitic Diseases Sofia Bulgaria

National HIV Reference Laboratory Chaim Sheba Medical Center Tel Hashomer Israel

National Institute for Infectious Diseases Prof dr Matei Bals Bucharest Romania

National Reference Laboratory for HIV AIDS National Institute of Public Health Prague Czech Republic

National Retrovirus Reference Center University of Athens Greece

on behalf of Cohorte de Adultos de la Red de Investigación en SIDA Spain

Rega Institute for Medical Research KU Leuven Belgium

Robert Koch Institute Berlin Germany

Slovak Medical University Bratislava Slovakia

St Elisabeth Hospital Tilburg The Netherlands

Statens Serum Institut Copenhagen Denmark

University College Dublin Ireland

University Hospital for Infectious Diseases Dr Fran Mihaljevic Zagreb Croatia

University of Bergen Norway

University of Cyprus Nicosia

University of Siena Italy

Citace poskytuje Crossref.org

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