Prevalence and Epidemiology of HIV Type 1 Drug Resistance among Newly Diagnosed Therapy-Naive Patients in Belgium from 2003 to 2006

Vercauteren, Jürgen; Derdelinckx, Inge; Sasse, André Deeke; Bogaert, Marleen; Ceunen, Helga; Roo, Ann De; Wit, Stéphane De; Deforche, Koen; Echahidi, Fedoua; Fransen, Katrien; Goffard, Jean-Christophe; Goubau, Patrick; Goudeseune, Elodie; Yombi, Jean‐Cyr; Lacor, Patrick; Liesnard, Corinne; Moutschen, Michel; Piérard, Denis; Rens, Roeland; Schrooten, Yoeri; Vaira, Dolorès; Heuvel, Annelies Van Den; Gucht, Beatrijs Van Der; Ranst, Marc Van; Wijngaerden, Eric Van; Vandercam, Bernard; Vekemans, Marc; Verhofstede, Chris; Clumeck, Nathan; Vandamme, Anne‐Mieke; Laethem, Kristel Van

doi:10.1089/aid.2007.0212

Cited by 32 publications

(22 citation statements)

References 27 publications

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“…This number corresponds with a number of other surveys in Europe [3,5,6,9,11,12,23], but several studies from Europe [4,8,24] and Northern America [7,10,25] report different frequencies. The majority of mutations were found in the substance class of NRTI.…”

Section: Discussionsupporting

confidence: 86%

“…Drug resistance in these patients, though never exposed to antiretroviral drugs, is defined as primary or transmitted resistance. This phenomenon has been addressed in a number of studies in recent years [2,3,4,5,6,7,8,9,10,11]. Different analyses showed reduced efficacy of ART in cases with primary drug resistance in bulk sequencing or as a minority strain [12,13,14,15,16,17,18].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of Transmitted Drug Resistance in Chronically HIV-Infected Patients in Germany: The RESINA Study 2001–2009

Oette

Reuter²,

Kaiser³

et al. 2012

Intervirology

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Objectives: Transmitted HIV drug resistance may impair treatment efficacy of combination antiretroviral therapy (ART). This study describes the epidemiology of transmitted resistance in chronically infected patients. Methods: In a prospective multicenter trial in Nordrhein-Westfalen, Germany, transmitted drug resistance was determined by genotypic resistance testing in patients on initiation of first-line ART. Results: From 2001 to 2009, 2,078 patients were enrolled in the study. 79.9% were male, 81.2% were Caucasians, and a homosexual transmission mode was found in 51.3%. Of these patients, 41.5% were at the stage of AIDS, median CD4 cell count was 230/µl, and median viral load was 64.466 copies/ml. Transmitted drug resistance mutations were seen in 9.2% (95% CI, 7.9–10.4). Resistance in the nucleoside reverse transcriptase inhibitor class was found in 5.8% (4.8–6.8), in the nonnucleoside reverse transcriptase inhibitor class in 2.8% (2.1–3.6), and in the protease inhibitor class in 2.7% (2.0–3.4). After a continuous increase to a level above 10% in the years 2006 and 2007, a decline of drug resistance prevalence followed in 2008 and 2009. Conclusions: Transmitted HIV drug resistance was found in around 10% of chronically infected patients in Germany who started their ART. We showed a moderate decline of the prevalence of mutant virus strains in recent years. Further surveillance of this phenomenon is mandatory.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Epidemiology of Transmitted Drug Resistance in Chronically HIV-Infected Patients in Germany: The RESINA Study 2001–2009

Oette

Reuter²,

Kaiser³

et al. 2012

Intervirology

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“…A rate of 5.7% can still be considered a modest estimate when compared to those of developed nations, where rates of 9-16% have been reported. [34][35][36][37][38][39][40] However, recent reports from Europe have pinpointed a stabilization of or a decrease in the rates of drug resistance, 41,42 indicating rates similar to or even lower that those found herein, suggesting that Brazil is reaching a primary drug resistance profile of developed settings.…”

Section: Discussionmentioning

confidence: 72%

Primary Antiretroviral Drug Resistance among HIV Type 1-Infected Individuals in Brazil

Sprinz

Netto

Lima

et al. 2009

AIDS Research and Human Retroviruses

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Infection with drug-resistant human immunodeficiency virus type 1 (HIV-1) has been documented in all countries that have surveyed for it and may result in an unfavorable response to therapy. The prevalence and characteristics of individuals with transmitted resistance to antiretroviral drugs have been scarcely described in Brazil. We performed antiretroviral resistance testing prior to initiation of therapy in 400 subjects enrolled from 20 centers in 13 Brazilian cities between March and September 2007. Genotyping was conducted using PCR-amplified HIV pol products by automated sequencing, and genotype interpretation was done according to the IAS-USA consensus. Of 400 eligible participants, 387 (95.8%) were successfully tested. Seven percent of antiretroviral-naive patients carried viruses with one or more major mutation associated with drug resistance. The prevalence of these mutations was 1.0% for protease inhibitors, 4.4% for nonnucleoside reverse transcriptase inhibitors, and 1.3% for nucleoside reverse transcriptase inhibitors. The frequency of multidrug resistance among the resistant strains was 13.6%. Among subjects infected with drug-resistant virus, the majority were infected with subtype B viruses (91%). Subjects from the city of São Paulo had higher transmitted resistance mutations compared to the rest of the country. Reporting a partner taking antiretroviral medications was associated with a higher chance of harboring HIV variants with major drug resistance mutations [odds ratio = 2.57 (95% confidence interval, 1.07-6.16); p = 0.014]. Resistance testing in drug-naive individuals identified 7% of subjects with mutations associated with reduced susceptibility to antiretroviral drugs. Continued surveillance of drug-resistant HIV-1 in Brazil is warranted when guidelines for HIV prophylaxis and treatment are updated. Resistance testing among drug-naive patients prior to treatment initiation should be considered, mainly directed at subjects whose partners are already on antiretroviral therapy.

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“…This prevalence is lower when compared to some studies conducted in North America and Europe with an overall resistance percentage of (18 %; P = 0.007) for USA [56], (25%; P = 0.001) for Greenland [57], (20.27 %; P = 0.001) and for Spain [58], while the reported prevalence in Portugal (7.78%; P = 0.410) [25], Belgium (9.5 %; P = 0.231) [59] and in one study conducted in 40 US cities (10%; P = 0.166) [60] was not so different. In contrast to most of the international studies we have reviewed, no major resistance mutations in reverse transcriptase gene were detected.…”

Section: Discussionmentioning

confidence: 98%

The prevalence of resistance-associated mutations to protease and reverse transcriptase inhibitors in treatment-naïve (HIV1)-infected individuals in Casablanca, Morocco

Bakhouch

Oulad-Lahcen²,

Bensghir³

et al. 2009

J Infect Dev Ctries

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Background: The widespread use of antiretroviral agents and the growing occurrence of HIV-1 strains resistant to these drugs have given rise to serious concerns regarding the transmission of resistant viruses to newly infected persons, which may reduce the efficacy of a first-line antiretroviral therapy. Methodology: RNA was extracted from plasma samples of 98 treatment-naïve individuals with a plasma HIV RNA viral load of at least 1,000 copies/ml. Both protease (pr) and reverse transcriptase (rt) were amplified and sequenced using an automated sequencer. National Agency for AIDS Research (ANRS) and Stanford HIV database algorithms were used for interpretation of resistance data. Results: In the protease segment, various minor mutations were present in the majority of the sequenced samples with high frequencies. Only two major mutations, M46L and V82L, were separately found in three individuals of 71 (4.2%) with one carrying both mutations. In the reverse transcriptase gene, no NNRTIs-associated resistance mutations were detected. Only one patient of 70 (1.4%) carried the F77L mutation that is associated with NRTIs resistance. Genetic subtyping revealed that 74.6% of samples were infected with subtype B, 15.5% with CRF02_AG, 4.2% with CRF01_AE, 1.4% with C, 2.8% with G and 1.4% with subtype F2. Conclusions: The low prevalence of major mutations associated with resistance to antiretroviral drugs (ARVs) among drug-naïve individuals studied suggests that the routine of drug resistance testing may be unnecessary for all Moroccan individuals newly diagnosed or all patients beginning antiretroviral therapy. Nevertheless, continuous surveillance is required since greater access to antiretroviral drugs is expected in Morocco.

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Prevalence and Epidemiology of HIV Type 1 Drug Resistance among Newly Diagnosed Therapy-Naive Patients in Belgium from 2003 to 2006

Cited by 32 publications

References 27 publications

Epidemiology of Transmitted Drug Resistance in Chronically HIV-Infected Patients in Germany: The RESINA Study 2001–2009

Epidemiology of Transmitted Drug Resistance in Chronically HIV-Infected Patients in Germany: The RESINA Study 2001–2009

Primary Antiretroviral Drug Resistance among HIV Type 1-Infected Individuals in Brazil

The prevalence of resistance-associated mutations to protease and reverse transcriptase inhibitors in treatment-naïve (HIV1)-infected individuals in Casablanca, Morocco

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