Evolving patterns of HIV‐1 transmitted drug resistance in Poland in the years 2000–2008

Abstract

The aim of the study was to determine the rate of transmission of drug resistant human immunodeficiency virus-1 (HIV-1) variants among therapy-naïve HIV positive patients in Poland in the year 2008, to compare the data with the results from the years 2000 to 2007 and to monitor patterns of HIV-1 subtypes present in Polish population and their evolution. Complete protease and part of reverse transcriptase regions were sequenced from the sera of patients directed to the laboratory for drug resistance testing. The Stanford's HIVdb program was used for the interpretation of results and subtyping. The variants scoring at least "intermediate resistance" for at least one drug were considered as resistant. The results obtained were compared to those obtained in the years 2000-2007. A total of 95 patients were enrolled in the 2008 study. Homosexual transmission of infection was documented in more than 55% of all cases. The overall prevalence of transmitted drug resistance (TDR) was 5.3% (3.9% in 2007, 5.8% in 2006, and 14.1% in the years 2002-2005). The study from the years 2000 to 2001 revealed 28.7% prevalence. Preliminary analysis of the first half of 2009 shows the ratio of 7.8%. In four (4.2%) cases drug resistance was associated with protease inhibitors class, in one case (1.1%) with resistance to non-nucleoside reverse transcriptase inhibitors class. In four cases (4.2%) non-B subtype was identified (C, G, CRF01_AE, CRF02_AG). An increase of percentage of drug resistant mutants-from 3.9% (2007) to 5.3% (2008)-was recognized. In this study, TDR was limited to single classes of antiretroviral drugs. HIV-1 subtype B prevails in Poland.

Molecular epidemiology of recent HIV‐1 infections in southern Poland

“…Namely, 79% of infections in the reference group were attributed to injecting drug users, and the majority of recent infections (55%) to sex between men. This is in concordance with other studies showing a gradual replacement of injecting drug users by men who have sex with men as the main transmission route among new HIV diagnoses in Poland [Firląg‐Burkacka et al, 2009; Stańczak et al, 2010; Werbinska‐Sienkiewicz et al, 2011]. The shift in transmission group may be the result of implemented effective harm reduction interventions, as well as changes over time in the routes of drug use from injecting to oral, nasal, or to inhalation.…”

HIV-1 Subtype D Infections among Caucasians from Northwestern Poland—Phylogenetic and Clinical Analysis

“…This may be the result of the increased degree of apoptosis in lymphocyte CD4 populations prior to the start of the antiretroviral treatment and a higher number of inhibitory programmed cell death receptors on the CD4 cells [34]. Mortality in the group was slightly higher if compared to the entire cohort (majority infected with the subtype B) from the region (3.44 versus 2.66 deaths per 100 person-years), which is in accordance to the previous reports [25], [35], [36], [37], [38]. Of note, all infections were associated with heterosexual transmissions with a percentage of infected women and mean age at diagnosis higher than among typical HIV positive population observed in Poland (75% versus 24.4%, respectively [26]).…”

Transmitted drug resistance to rilpivirine among antiretroviral‐naïve patients living with HIV from northern Poland

“…It should be observed that prevalence of the RPV key drug resistance mutations in our sample is higher than that of the K103N mutation, observed in 2.1% of cases, while etravirine resistance-associated mutations were rare (one sequence each with K238T and Y318F). So far, for Poland the data are very limited, with single cases of NNRTI-transmitted drug resistance [28]. …”