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

• Published in: Infection Ecology & Epidemiology
• Main Authors: Sallam, Malik, Şahin, Gülşen Özkaya, Indriðason, Hlynur, Esbjörnsson, Joakim, Löve, Arthur, Widell, Anders, Gottfreðsson, Magnus, Medstrand, Patrik
• Other Authors: 1 Faculty of Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden. 2 Clinical Microbiology, Laboratory Medicine Skåne, Lund, Sweden. 3 Faculty of Medicine, Department of Laboratory Medicine, Section of Microbiology, Immunology and Glycobiology, Lund University, Lund, Sweden. 4 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 5 Nuffield Department of Medicine, University of Oxford, Oxford, UK. 6 Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden. 7 Department of Virology, Landspítali University Hospital, Reykjavik, Iceland. 8 Department of Infectious Diseases, Landspítali University Hospital, Reykjavik, Iceland.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis 2018
• Subjects: HIV-jákvæðir; Lyfhrifafræði; TMD12; VEI12; Drug Resistance; HIV; Anti-Retroviral Agents; Iceland
• Online Access: http://hdl.handle.net/2336/620497; https://doi.org/10.1080/20008686.2017.1328964

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files 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.Abbreviations: 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-WhitneyUtest; NFV: ...