Transmission of HIV drug resistance and non-B subtype distribution in the Spanish cohort of antiretroviral treatment naïve HIV-infected individuals (CoRIS)

García, Féderico; Pérez-Cachafeiro, Santiago; Guillot, Vicente; Álvarez, Marta; Pérez‐Romero, Pilar; Pérez-Elías, María Jesús; Viciana, Isabel; Blanco, José Ramón; López-Diéguez, María; Mendoza, Carmen de

doi:10.1016/j.antiviral.2011.05.010

Cited by 35 publications

(40 citation statements)

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“…The results presented confirmed that subtype B is still the main HIV-1 variant in Spain, as reported previously for the same sample of subjects from CoRIS (16), and are concordant with data from other Spanish studies (23,31,34). What our study adds is the finding that 8.8% of the 670 CoRIS patients (14% of the 164 patients assessed in 2008) were infected with HIV-1 recombinant variants (CRFs and URFs) and the description of the genetic nature of the complex recombinants.…”

Section: One Of 10 Hiv-1-infections In Spain Could Represent Recombinsupporting

confidence: 81%

“…The coexistence of multiple variants in the same region favors recombination between them after coinfection and/or superinfection events. In Spain, an increase in the frequency of HIV-1 non-B subtypes has been found among native Spaniards and immigrants newly diagnosed with HIV-1 in recent years (23), and the presence of different recombinants has been published (11,14,16,21,23,24,34,52,53).…”

mentioning

confidence: 99%

“…CoRIS, the cohort of the Spanish Research Network of Excellence on HIV/AIDS, has recently reported a prevalence of 15.2% for HIV-1 non-B subtypes (16). To further explore the molecular epidemiology of HIV in Spain, the objective of the present study was to characterize the HIV-1 recombinant variants detected in CoRIS by using phylogenetic analysis (phy), the gold-standard method for subtyping and discrimination between subtypes and/or CRFs.…”

mentioning

confidence: 99%

“…HIV-1 subtype B is the prevalent variant in developed areas, such as North America and Western Europe, including Spain (16,23). However, subtypes other than subtype B and recombinants (HIV-1 non-B variants) are responsible for 90% of the 33 million infections worldwide (20,46).…”

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confidence: 99%

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Most HIV Type 1 Non-B Infections in the Spanish Cohort of Antiretroviral Treatment-Naïve HIV-Infected Patients (CoRIS) Are Due to Recombinant Viruses

et al. 2012

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HIV-1 group M is classified into 9 subtypes, as well as recombinants favored by coinfection and superinfection events with different variants. Although HIV-1 subtype B is predominant in Europe, intersubtype recombinants are increasing in prevalence and complexity. In this study, phylogenetic analyses of pol sequences were performed to detect the HIV-1 circulating and unique recombinant forms (CRFs and URFs, respectively) in a Spanish cohort of antiretroviral treatment-naïve HIV-infected patients included in the Research Network on HIV/AIDS (CoRIS). Bootscanning and other methods were used to define complex recombinants not assigned to any subtype or CRF. A total of 670 available HIV-1 pol sequences from different patients were collected, of which 588 (87.8%) were assigned to HIV-1 subtype B and 82 (12.2%) to HIV-1 non-B variants. Recombinants caused the majority (71.9%) of HIV-1 non-B infections and were found in 8.8% of CoRIS patients. Eleven URFs (accounting for 13.4% of HIV-1 non-B infections), presenting complex mosaic patterns, were detected. Among them, 10 harbored subtype B fragments. Four of the 11 URFs were found in Spanish natives. A cluster of three B/CRF02_AG recombinants was detected. We conclude that complex variants, including unique recombinant forms, are being introduced into Spain through both immigrants and natives. An increase in the frequency of mosaic viruses, reflecting the increasing heterogeneity of the HIV epidemic in our country, is expected.

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Section: One Of 10 Hiv-1-infections In Spain Could Represent Recombinsupporting

confidence: 81%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Most HIV Type 1 Non-B Infections in the Spanish Cohort of Antiretroviral Treatment-Naïve HIV-Infected Patients (CoRIS) Are Due to Recombinant Viruses

et al. 2012

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“…Recent large populationbased studies in the United States, Africa, and Europe have found TDR rates in the range of 6%-16%, with higher levels of resistance in certain urban populations, particularly those who engage in high-risk sex and intravenous drug users (Table 2). [101][102][103][104][105][106][107][108][109][110] In a study of 1277 newly infected patients with HIV-1 in South Carolina, 184 (14%) had TDR. 54 (4%) had an NRTI mutation, 37 (3%) had a PI mutation, and 126 (10%) had an NNRTI mutation.…”

Section: Resistancementioning

confidence: 99%

Issues in resistance, adherence, and comparative efficacy of the single-tablet regimen combination of tenofovir, emtricitabine, and efavirenz in the management of HIV-1 infection

Rebick¹,

Walmsley²

2012

VAAT

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Abstract:Atripla is the first once-daily, single-tablet, triple-combination antiretroviral therapy. It is recommended for the initial treatment of the naïve patient with human immunodeficiency virus-1 (HIV-1) infection in all current guidelines, based on its proven efficacy in numerous head-to-head randomized clinical trials. Not only has it proven efficacy, but the fixed-dose combination, Atripla, has resulted in an improvement in adherence, quality of life, and satisfaction among naïve as well as virally suppressed patients switching from another regimen. Despite the advantages, tolerability issues can arise that are related primarily to the efavirenz component, which is known to cause central nervous side effects such as dizziness, abnormal dreams, and anxiety. Although generally self-limited, these side-effects can lead to treatment discontinuation in the short-or long-term. Based on the observation of neural tube defects in macaque models, and isolated case reports in human fetuses with first trimester exposure, it is rated as Food and Drug Administration pregnancy category D, and considered as contraindicated in the first trimester of pregnancy where alternatives are available. Given the low genetic barrier of each of the individual components, resistance remains an important issue for patients with poor adherence, but is balanced in part by the long half-life of the drugs. Transmitted resistance is described in up to 16% of newly infected patients in population surveys, and is particularly prevalent in men who have sex with men. Minority variants that may impart resistant to efavirenz are not detected with currently used HIV-1 genotype assays, but nonetheless may also be implicated in patients who fail initial treatment. Several single-tablet regimens are recently licensed or in development that will challenge Atripla as the single-tablet first-line option, but none have shown superior efficacy to date.

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Emergence of uncommon HIV‐1 non‐B subtypes and circulating recombinant forms and trends in transmission of antiretroviral drug resistance in patients with primary infection during the 2013‐2015 period in Marseille, Southeastern France

Tamalet

Tissot‐Dupont

Motte

et al. 2018

Journal of Medical Virology

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Primary HIV-1 infections (PHI) with non-B subtypes are increasing in developed countries while transmission of HIV-1 harboring antiretroviral resistance-associated mutations (RAMs) remains a concern. This study assessed non-B HIV-1 subtypes and RAMs prevalence among patients with PHI in university hospitals of Marseille, Southeastern France, in 2005-2015 (11 years). HIV-1 sequences were obtained by in-house protocols from 115 patients with PHI, including 38 for the 2013-2015 period. On the basis of the phylogenetic analysis of the reverse transcriptase region, non-B subtypes were identified in 31% of these patients. They included 3 different subtypes (3A, 1C, 4F), 23 circulating recombinant forms (CRFs) (CRF02_AG, best BLAST hits being CRF 36_cpx and CRF30 in 7 and 1 cases, respectively), and 5 unclassified sequences (U). Non-B subtypes proportion increased significantly, particularly in 2011-2013 vs in 2005-2010 (P = .03). CRF02_AG viruses largely predominated in 2005-2013 whereas atypical strains more difficult to classify and undetermined recombinants emerged recently (2014-2015). The prevalence of protease, nucleos(t)ide reverse transcriptase, and first-generation nonnucleoside reverse transcriptase inhibitors-associated RAMs were 1.7% (World Health Organization [WHO] list, 2009/2.6% International AIDS Society [IAS] list, 2017), 5.2%/4.3%, and 5.2%/5.2%, respectively. Etravirine/rilpivirine-associated RAM (IAS) prevalence was 4.3%. Men who have sex with men (MSM) were more frequently infected with drug-resistant viruses than other patients (26% vs 7%; P = .011). The recent increase of these rare HIV-1 strains and the spread of drug-resistant HIV-1 among MSM in Southeastern France might be considered when implementing prevention strategies and starting therapies.

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Transmission of HIV drug resistance and non-B subtype distribution in the Spanish cohort of antiretroviral treatment naïve HIV-infected individuals (CoRIS)

Cited by 35 publications

References 17 publications

Most HIV Type 1 Non-B Infections in the Spanish Cohort of Antiretroviral Treatment-Naïve HIV-Infected Patients (CoRIS) Are Due to Recombinant Viruses

Most HIV Type 1 Non-B Infections in the Spanish Cohort of Antiretroviral Treatment-Naïve HIV-Infected Patients (CoRIS) Are Due to Recombinant Viruses

Issues in resistance, adherence, and comparative efficacy of the single-tablet regimen combination of tenofovir, emtricitabine, and efavirenz in the management of HIV-1 infection

Emergence of uncommon HIV‐1 non‐B subtypes and circulating recombinant forms and trends in transmission of antiretroviral drug resistance in patients with primary infection during the 2013‐2015 period in Marseille, Southeastern France

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