Prevalence of Drug-Resistant HIV-1 Variants in Untreated Individuals in Europe: Implications for Clinical Management

• Published in: The Journal of infectious diseases Vol. 192; no. 6; pp. 958 - 966
• Main Authors: Wensing, Annemarie M. J., van de Vijver, David A., Angarano, Gioacchino, Åsjö, Birgitta, Balotta, Claudia, Boeri, Enzo, Camacho, Ricardo, Chaix, Maire-Laure, Costagliola, Dominique, De Luca, Andrea, Derdelinckx, Inge, Grossman, Zehava, Hamouda, Osamah, Hatzakis, Angelos, Hemmer, Robert, Hoepelman, Andy, Horban, Andrzej, Korn, Klaus, Kücherer, Claudia, Leitner, Thomas, Loveday, Clive, MacRae, Eilidh, Maljkovic, Irina, de Mendoza, Carmen, Meyer, Laurence, Nielsen, Claus, Op de Coul, Eline L., Ormaasen, Vidar, Paraskevis, Dimitris, Perrin, Luc, Puchhammer-Stöckl, Elisabeth, Ruiz, Lidia, Salminen, Mika, Schmit, Jean-Claude, Schneider, Francois, Schuurman, Rob, Soriano, Vincent, Stanczak, Grzegorz, Stanojevic, Maja, Vandamme, Anne-Mieke, Van Laethem, Kristel, Violin, Michela, Wilbe, Karin, Yerly, Sabine, Zazzi, Maurizio, Boucher, Charles A.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.09.2005; University of Chicago Press; Oxford University Press
• Subjects: Adult; AIDS; Amino Acid Substitution; Antiretrovirals; Antivirals; Biological and medical sciences; Disease transmission; Drug resistance; Drug Resistance, Viral - genetics; Europe; Female; Fundamental and applied biological sciences. Psychology; Genetic mutation; HIV; HIV 1; HIV Infections - drug therapy; HIV Infections - virology; HIV-1 - drug effects; HIV-1 - genetics; HIV/AIDS; Human immunodeficiency virus 1; Humans; Infections; Infectious diseases; Male; Medical sciences; Microbiology; Miscellaneous; Mutation, Missense; Virology; Viruses; Europe; Virus; Infection; Resistance; Clinical management; Prevalence; Microbiology; HIV-1 virus; Retroviridae; Human immunodeficiency virus; Lentivirus; Epidemiology
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/432916

BackgroundInfection with drug-resistant human immunodeficiency virus type 1 (HIV-1) can impair the response to combination therapy. Widespread transmission of drug-resistant variants has the disturbing potential of limiting future therapy options and affecting the efficacy of postexposure prophylaxis penta increase-spacing 1>MethodsWe determined the baseline rate of drug resistance in 2208 therapy-naive patients recently and chronically infected with HIV-1 from 19 European countries during 1996–2002 ResultsIn Europe, 1 of 10 antiretroviral-naive patients carried viruses with ⩾1 drug-resistance mutation. Recently infected patients harbored resistant variants more often than did chronically infected patients (13.5% vs. 8.7%; P=.006). Non-B viruses (30%) less frequently carried resistance mutations than did subtype B viruses (4.8% vs. 12.9%; P<.01). Baseline resistance increased over time in newly diagnosed cases of non-B infection: from 2.0% (1/49) in 1996–1998 to 8.2% (16/194) in 2000–2001 ConclusionsDrug-resistant variants are frequently present in both recently and chronically infected therapy-naive patients. Drug-resistant variants are most commonly seen in patients infected with subtype B virus, probably because of longer exposure of these viruses to drugs. However, an increase in baseline resistance in non-B viruses is observed. These data argue for testing all drug-naive patients and are of relevance when guidelines for management of postexposure prophylaxis and first-line therapy are updated