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

  • HIV Clinical and Translational Research
July 21, 2014 By:
  • Frentz D
  • Van de Vijver DA
  • Abecasis AB
  • Albert J
  • Hamouda O
  • Jorgensen LB
  • Kucherer C
  • Struck D
  • Schmit JC
  • Vercauteren J
  • Asjo B
  • Balotta C
  • Beshkov D
  • Camacho RJ
  • Clotet B
  • Coughlan S
  • Griskevicius A
  • Grossman Z
  • Horban A
  • Kolupajeva T
  • Korn K
  • Kostrikis LG
  • Liitsola K
  • Linka M
  • Nielsen C
  • Otelea D
  • Paraskevis D
  • Paredes R
  • Poljak M
  • Puchhammer-Stockl E
  • Sonnerborg A
  • Stanekova D
  • Stanojevic M
  • Van Wijngaerden E
  • Wensing AM
  • Boucher CA
  • Spread Programme.

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.

2014 Jul. BMC Infect Dis.14:407.
Other information