Declining Prevalence of HIV-1 Drug Resistance in Antiretroviral Treatment-exposed Individuals in Western Europe

Abstract

HIV-1 drug resistance represents a major obstacle to infection and disease control. This retrospective study analyzes trends and determinants of resistance in antiretroviral treatment (ART)-exposed individuals across 7 countries in Europe. Of 20 323 cases, 80% carried at least one resistance mutation: these declined from 81% in 1997 to 71% in 2008. Predicted extensive 3-class resistance was rare (3.2% considering the cumulative genotype) and peaked at 4.5% in 2005, decreasing thereafter. The proportion of cases exhausting available drug options dropped from 32% in 2000 to 1% in 2008. Reduced risk of resistance over calendar years was confirmed by multivariable analysis.

Burden of Nonnucleoside Reverse Transcriptase Inhibitor Resistance in HIV-1-Infected Patients: A Systematic Review and Meta-Analysis

“…175 Gupta et al (2008) 176 conducted a systematic literature review and meta-analysis of patients failing HAART treatment among clinical trials to estimate resistance to the NNRTI third agent occurred in 53% of patients after 48 weeks of follow-up, consistent with our study.…”

Impact of Fixed-Dose Combinations of Antiretrovirals on Prevalence Trends of HIV Resistance: A 7 Year Follow-Up Study

“…Bracciale et al [16] found that more recent calendar year was predictor of more effective ARV treatment. Recently, a study in Western Europe, found an association between later calendar years and reduced probability of resistance [29]. However this is a retrospective study, not fully representative of the HIV+ population, and they did not investigate the relationship with prescription or exposure patterns.…”

2-Aminothiazolones as Anti-HIV Agents That Act as gp120-CD4 Inhibitors

“…Chemical shifts are reported relative to (CH 3 ) 4 Si at a ␦ value of 0.00 ppm (see supplemental material). Melting points were measured using a Gallenkamp melting point apparatus and are uncorrected.…”

“…Drug discovery and development have transformed HIV-1 infection into a chronic condition that can be controlled for many years through combination therapies with different classes of antiretroviral drugs, known as highly active antiretroviral therapy (HAART) (1). However, the need for lifelong use of HAART and the emergence of resistance to these drugs underscore the need to develop newer inhibitors with reduced toxicity and improved activity and resistance profiles (2)(3)(4). The attachment of HIV to host cells occurs via binding of the HIV envelope glycoprotein gp120 to the host CD4 receptor; thus, the inhibition of this protein-protein interaction offers an effective target in the development of new antiretroviral agents (5,6).…”