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

Abstract

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

Epidemiological surveillance of HIV-1 transmitted drug resistance among newly diagnosed individuals in Shijiazhuang, northern China, 2014–2015

“…No significant differences were observed between the prevalence of TDR and demographic characteristic, which was similar with a previous study [ 36 , 37 ]. Many studies reported that the higher prevalence of TDR among MSM compared to heterosexuals; interestingly, the opposite results also were found in others reports [ 38 – 40 ].…”

Prevalence of Pretreatment and Acquired HIV-1 Mutations Associated with Resistance to Lamivudine or Rilpivirine: A Systematic Review

“…Africa had the highest number of articles identified in the search of any region (n=30) . However, the European region had the highest number of participants for analysis of pretreatment resistance mutations (n=33,957 for NRTI-associated mutations; n=34,201 for NNRTI-associated mutations) [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60], and Southeast Asia had the highest number of participants for analysis of acquired resistance mutations (n=26,772 for NRTI-associated mutations; 26,568 for NNRTI-associated mutations) [61][62][63][64][65][66][67][68][69].…”

“…The estimated global prevalence of pretreatment DRMs was 4% (n=2,719/60,567; range, 2% [Asia Pacific] to 6% [North America]) for those associated with NRTI resistance [16,18,25,28,[30][31][32][35][36][37][38]40,43,44,46,48,49,[51][52][53][54][55][56][57][58][59][60] and 6% (n=3,605/61,402; range, 3% [Asia Pacific] to 8% [Africa and North America]) for those associated with resistance to any NNRTI (Figure 1) [16,18,25,28,[30][31][32][33][34][35][36][37][38][39]41,[70][71][72][73][74][75]…”

“…Among reports with available data, 77% (n=702/917) and 80% (n=730/908) had acquired DRMs conferring resistance to the NRTI and NNRTI classes, respectively. The most frequent acquired 3TC/FTC DRMs were at position M184 (70%; n=2,255/3,240); the most frequent acquired RPV DRMs were at position Y181 (19%; n=611/3,191).Regional prevalence estimates: EuropeIn European studies, there were 33,957 people with data related to pretreatment NRTI-associated DRMs and 34,201 people with data on NNRTI-associated DRMs (Supplemental Tables6 and 7in Additional file 1)[43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60]. Pretreatment DRMs with NRTI ance to NRTIs was observed in 70% (n=1,846/2,633), whereas resistance to NNRTIs was observed in 52% (n=1,382/2,633).…”

The Estimation of Transmitted Drug Resistance Mutation Strains Probability in the Treatment of HIV Using the Beta-Binomial Model

“…According to [12], viral load, symptoms, CD4 counts, transmission route, and the duration of ART are associated with HIV-1 DR. Resistance to antiretroviral drugs can complicate the management of HIV-1infection and impair control of its spread. Screening for TDF is recommended to limit its local spread and to optimize HIV-1 therapy [13]. Test-and-treat programs are central to the global control of HIV, but transmitted drug resistance threatens the effectiveness of these programs [14].…”