The Epidemiology of Antiretroviral Drug Resistance among Drug‐Naive HIV‐1–Infected Persons in 10 US Cities

Weinstock, Hillard; Zaidi, Irum; Heneine, Walid; Bennett, Diane; García-Lerma, G; Douglas, John M.; LaLota, Marlene; Dickinson, Gordon M.; Schwarcz, Sandra; Torian, Lucia V.; Wendell, Deborah; Paul, Sindy M.; Goza, Garald A.; Ruiz, Juan; Boyett, Brian; Kaplan, Jonathan E.

doi:10.1086/420789

Cited by 226 publications

(213 citation statements)

References 29 publications

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“…In particular, in drug-naive MSM individuals, resistance (3.9%) is lower than that observed in other studies performed on the same risk class [52][53][54] and in other studies performed on heterogeneous risk classes. [55][56][57][58] The prevalence of resistance in antiretroviral-treated MSM individuals is around 60%, with a decreased trend over the years 2004-2006 (data not shown), in line with that observed in recent studies; 59,60 this diminished trend could explain the low prevalence of drug resistance in naive patients.…”

Section: Discussionsupporting

confidence: 87%

Non-B HIV Type 1 Subtypes among Men Who Have Sex with Men in Rome, Italy

Giuliani

Montieri

Palamara

et al. 2009

AIDS Research and Human Retroviruses

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An increase in the circulation of HIV-1 non-B subtypes has been observed in recent years in Western European countries. Due to the lack of data on the circulation of HIV-1 non-B subtypes among European HIV-1-infected men who have sex with men (MSM), a biomolecular study was conducted in Rome, Italy. HIV-1 partial pol gene sequences from 111 MSM individuals (76 drug naive and 35 drug experienced) were collected during the years [2004][2005][2006]. All these sequences were analyzed using the REGA HIV-1 Subtyping Tool, and aligned using CLUSTAL X followed by manual editing using the Bioedit software. A BLAST search for non-B subtype sequences was also performed. Twenty-six (23.4%) MSM were not Italians. Eight individuals (7.2%) were diag- The CRFs were more prevalent (8.1%) than pure subtypes (5.4%), which were distributed as follows: subtype C (2.6%), subtype A1 (1.7%), and subtype F1 (0.9%). Major mutations conferring resistance to antiretroviral drugs (ARV) were not found among HIV-1 non-B subtype drugnaive patients but were found in two ARV-experienced individuals. The data show that viral diversity is likely increasing in a population group that had been previously characterized by the circulation of HIV-1 subtype B.

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Section: Discussionsupporting

confidence: 87%

Non-B HIV Type 1 Subtypes among Men Who Have Sex with Men in Rome, Italy

Giuliani

Montieri

Palamara

et al. 2009

AIDS Research and Human Retroviruses

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“…Finally, K219E, also a thymidine analog mutation, confers moderate phenotypic and clinical resistance to ZDV and d4T. K103N, conferring resistance to NVP and EFV [35], was not detected in any of the ART-naive patients. Y181I, Y188H, and L100I were major NNRTI mutations (Table 3) detected in two, one, and one patients, respectively.…”

Section: Drug Resistance Mutations Among the Study Participantsmentioning

confidence: 92%

Screening for antiretroviral drug resistance among treatment-naive human immunodeficiency virus type 1-infected individuals in Lebanon

Mokhbat

Melhem

El‐Khatib

et al. 2014

J Infect Dev Ctries

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Introduction: Antiretroviral therapy (ART) has been successful at decreasing the morbidity and mortality associated with human immunodeficiency virus type 1 (HIV-1) infection. HIV-1 drug resistance (HIVDR) among ART-naive patients has been documented to compromise the success of initial therapy. This study was conducted to determine the prevalence of HIVDR mutations among newly diagnosed drug-naive HIV-infected individuals in Lebanon. Methodology: Plasma samples from 37 newly diagnosed participants at various stages of HIV-1 infection were used to determine HIV-1 RNA viral load, isolate viral RNA, and amplify DNA by RT-PCR. Purified PCR products were used to perform genotypic resistance tests. Results: The prevalence of resistance mutations to nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRT), and protease inhibitors (PI) were 5.4%, 10.8%, and 8%, respectively. The major mutations detected in the study participants conferred resistance to NRTIs and NNRTIs recommended for HIV-1 treatment. No significant relationship between HIV-1 viral load of participants and the mode of HIV-1 transmission or between the occurrence of HIVDR and the mode of transmission was found. Conclusions: To our knowledge, this is the first study on HIVDR mutations among newly diagnosed HIV-infected persons in Lebanon. The overall prevalence of HIVDR mutations detected in our study was 16%. Our results are important for evaluating the utility of the standard first-line regimens in use, determining the feasibility of HIVDR testing before the initiation of ART, as well as minimizing the emergence and transmission of HIVDR.

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“…Whereas genotyping is becoming common practice in resource-rich countries, it is too costly to fully implement in developing countries [85,91]. Standard genotyping methods detect mutants of dominant species or give a composite of HIV sequences present but are generally unable to detect low frequency mutants that comprise less than 20% of the total HIV population [92,93].…”

Section: Hiv Monitoring and Managementmentioning

confidence: 99%

HIV Diagnostics: Challenges and Opportunities

Wong

Hewlett

2010

HIV Ther.

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Accurate HIV diagnostic testing continues to pose challenges, but there are also opportunities for assay performance improvements in key areas for specific intended-use settings. The genetic diversity of HIV can result in false and discordant results in assays that fail to detect new variant strains. The use of antiretroviral therapies has resulted in drug-resistant variants that require monitoring by sequencing and genotyping methods. Nucleic acid testing is the most sensitive and reliable platform for detection, but it is costly and limited to centralized testing facilities, making implementation difficult in resource-limited settings where HIV has hit the hardest. Rapid antibody tests suitable for point-of-care use are becoming more accessible in resource-limited settings, but these tests may not detect HIV during the acute infection stage. Emerging antigen/antibody combination assays are viable alternatives to nucleic acid testing for diagnosis of recent infections. Although patient monitoring (e.g., via CD4+ T-cell count and viral load determination) and infant diagnoses still rely on clinical laboratory-based testing, point-of-care options are being developed. There are other technical challenges to HIV diagnostic testing and emerging biodetection technologies that may be able to address them, but they are not yet proven.

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The Epidemiology of Antiretroviral Drug Resistance among Drug‐Naive HIV‐1–Infected Persons in 10 US Cities

Abstract: Depending on the characteristics of the patients tested, HIV-genotype testing prior to the initiation of therapy would identify a substantial number of infected persons with mutations associated with reduced antiretroviral-drug susceptibility.

Cited by 226 publications

References 29 publications

Non-B HIV Type 1 Subtypes among Men Who Have Sex with Men in Rome, Italy

Non-B HIV Type 1 Subtypes among Men Who Have Sex with Men in Rome, Italy

Screening for antiretroviral drug resistance among treatment-naive human immunodeficiency virus type 1-infected individuals in Lebanon

HIV Diagnostics: Challenges and Opportunities

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