Molecular Phylogenetics of Transmitted Drug Resistance in Newly Diagnosed HIV Type 1 Individuals in Denmark, a Nation-Wide Study

Audelin, Anne Margrethe; Gerstoft, Jan; Obel, Niels; Mathiesen, Lars; Laursen, Alex Lund; Pedersen, Court; Nielsen, Henry; Jensen, Jeanette Dupont; Nielsen, Lars N.; Nielsen, Claus Henrik; Jørgensen, Lars

doi:10.1089/aid.2010.0368

Cited by 26 publications

(25 citation statements)

References 28 publications

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“…This result is slightly higher compared to other Nordic countries. [22,23] Nevertheless; our prevalence estimate was within the range reported in recent studies which investigated the prevalence of TDR in other Western European countries. [24–26] The inclusion of patients diagnosed in the 1990s might have influenced our prevalence estimate.…”

Section: Discussionsupporting

confidence: 84%

Decreasing prevalence of transmitted drug resistance among ART-naive HIV-1-infected patients in Iceland, 1996–2012

Sallam

Şahin

Indriðason

et al. 2017

Infection Ecology & Epidemiology

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Introduction: Resistance to antiretroviral drugs can complicate the management of HIV-1 infection and impair control of its spread. The aim of the current study was to investigate the prevalence and transmission of HIV-1 drug resistance among 106 antiretroviral therapy (ART)-naïve patients diagnosed in Iceland (1996–2012). Methods: HIV-1 polymerase sequences were analysed using the Calibrated Population Resistance tool. Domestic spread of transmitted drug resistance (TDR) was investigated through maximum likelihood and Bayesian approaches. Results: Among ART-naïve patients, the prevalence of TDR to any of the following classes (NRTIs, NNRTIs and PIs) was 8.5% (95% CI: 4.5%- 15.4%): 6.6% to NRTIs, 0.9% to NNRTIs, and 1.9% to PIs. The most frequent NRTI mutation detected was T215C/D (n=7, 5.7%). The only NNRTI mutation detected was K103N (n=1, 0.9%). PI mutations detected were M46I (n=1, 0.9%) and L90M (n=1, 0.9%). Six patients harbouring T215C/D, were linked in a supported phylogenetic cluster. No significant association was found between TDR and demographic or risk groups. Trend analysis showed a decrease in the prevalence of TDR (1996–2012, p=0.003). Conclusions: TDR prevalence in Iceland was at a moderate level and decreased during 1996-2012. Screening for TDR is recommended to limit its local spread and to optimize HIV-1 therapy. A bbreviations: ART: Anti-retroviral therapy; ARV: antiretroviral; ATV/r: atazanavir/ritonavir; AZT: azidothymidine; BEAST: Bayesian evolutionary analysis by sampling trees; CI: confidence interval; CPR: calibrated population resistance; CRF: circulating recombinant form; d4T: stavudine; EFV: efavirenz; FET: Fishers’ exact test; FPV/r: fosamprenavir/ritonavir; HET: heterosexual; IDU: injection drug use; IDV/r: indinavir/ritonavir; LPV/r: lopinavir/ritonavir; MSM: men who have sex with men; M-W: Mann–Whitney U test; NFV: nelfinavir; NNRTIs: non-nucleoside reverse transcriptase inhibitors; NRTIs: nucleoside reverse transcriptase inhibitors; NVP: nevirapine; PIs: protease inhibitors; pol: polymerase gene; SDRM: surveillance drug resistance mutation; SQV/r: saquinavir/ritonavir; TDR: transmitted drug resistance

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Section: Discussionsupporting

confidence: 84%

Decreasing prevalence of transmitted drug resistance among ART-naive HIV-1-infected patients in Iceland, 1996–2012

Sallam

Şahin

Indriðason

et al. 2017

Infection Ecology & Epidemiology

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“…The Center for Disease Control and Prevention has estimated that the corresponding proportion in the United States is only 35% [18]. This difference is mainly due to lower rates of linkage to and retention in care.…”

Section: Discussionmentioning

confidence: 99%

HIV Care in the Swedish-Danish HIV Cohort 1995-2010, Closing the Gaps

et al. 2013

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BackgroundSuccessful treatment reduces morbidity, mortality and transmission of HIV. We evaluated trends in the treatment status of HIV infected individuals enrolled in care in Sweden and Denmark during the years 1995-2010. Our aim was to assess the proportion of HIV-infected individuals who received services along the continuum of care in Denmark in 2010, and to discuss the findings in relation to the organization of the health care system.MethodsWe analyzed CD4 counts and viral loads (VL) among all HIV patients enrolled in the cohort. For each month of the study period we estimated the proportions of patients who 1) had initiated highly active antiretroviral treatment (HAART) and had VL<500 copies/mL, 2) were not eligible for HAART, 3) had initiated HAART but had VL≥500 copies/mL, 4) were eligible for, but had not initiated HAART and 5) had initiated HAART but no VL monitoring for >13 months or 6) no HAART or monitoring of CD4 for >13 months. Patients fulfilling criteria 1 or 2 were considered successfully managed.ResultsThe proportion of successfully managed patients continued to increase throughout the study period and reached 83% in 2010, 92% of Swedish/Danish men who have sex with men and heterosexual patients, but only 74% of immigrants and 78% of injection drug users were successfully managed due to higher rates of inadequate monitoring in the latter two groups. In 2010, 70% of all individuals diagnosed with HIV in Denmark were virally suppressed.ConclusionIn a public health care system with free access to specialized care, successful management of the majority of HIV patients is achievable. Interventions tailored to retain immigrants and injection drug users in care are needed to further reduce the proportion of sub-optimally treated HIV patients.

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“…Transmission clusters were defined as having Shimodaira-Hasegawa node support greater than 0.90 and mean pairwise genetic distance less than 0.03 substitutions per site, a definition that is consistent with other similar published studies. 13-15 …”

Section: Methodsmentioning

confidence: 99%

Brief Report

Truong

Pipkin

O’Keefe

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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There were 1,311 newly-diagnosed HIV cases in San Francisco between 2005 and 2011 that were linked to care at publicly-funded facilities and had viral sequences available for analysis. Of the 214 cases characterized as recently-infected with HIV at time of diagnosis, 25% had a recent sexually transmitted infection (STI) diagnosis (vs. 10% among longer-standing HIV infections, p<0.001) and 57% were part of a phylogenetic transmission cluster (vs. 42% among longer-standing HIV infection, p<0.001). The association observed between recent HIV infection and having a STI diagnosis during the interval overlapping likely HIV acquisition points to potential opportunities to interrupt HIV transmission.

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Molecular Phylogenetics of Transmitted Drug Resistance in Newly Diagnosed HIV Type 1 Individuals in Denmark, a Nation-Wide Study

Cited by 26 publications

References 28 publications

Decreasing prevalence of transmitted drug resistance among ART-naive HIV-1-infected patients in Iceland, 1996–2012

Decreasing prevalence of transmitted drug resistance among ART-naive HIV-1-infected patients in Iceland, 1996–2012

HIV Care in the Swedish-Danish HIV Cohort 1995-2010, Closing the Gaps

Brief Report

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