Transmission of drug-resistant HIV-1 in Europe remains limited to single classes

被引：99

作者：

Wensing, Annemarie M. J. ^{[1
]}

Vercauteren, Jurgen ^{[2
]}

van de Vijver, David A. ^{[1
]}

Albert, Jan ^{[3
]}

Asjo, Birgitta ^{[4
]}

Balotta, Claudia ^{[5
]}

Camacho, Ricardo ^{[6
]}

Coughlan, Suzie ^{[7
]}

Grossman, Zehava ^{[8
]}

Horban, Andrzej ^{[9
]}

Kucherer, Claudia ^{[10
]}

Nielsen, Claus ^{[11
]}

Paraskevis, Dimitris ^{[12
]}

Loke, Wei C. ^{[13
]}

Poggensee, Gabrielle ^{[10
]}

Puchhammer-Stockl, Elisabeth ^{[14
]}

Riva, Chiara ^{[5
]}

Ruiz, Lidia ^{[15
]}

Schmit, Jean-Claude ^{[16
]}

Schuurman, Rob ^{[1
]}

Salminen, Mika ^{[17
]}

Sonnerborg, Anders ^{[18
]}

Stanojevic, Maja ^{[19
]}

Struck, Daniel ^{[16
]}

Vandamme, Anne-Mieke ^{[2
]}

Boucher, Charles A. B. ^{[1
]}

机构：

[1] Univ Med Ctr Utrecht, Eijkman Winkler Inst, Dept Virol, Utrecht, Netherlands

[2] Katholieke Univ Leuven, Louvain, Belgium

[3] Swedish Inst Infect Dis Control, Solna, Sweden

[4] Univ Bergen, Bergen, Norway

[5] Univ Milan, Milan, Italy

[6] Hosp Egas Moniz, Lisbon, Portugal

[7] Univ Coll Dublin, Natl Virus Reference Lab, Dublin 2, Ireland

[8] Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel

[9] Hosp Infect Dis & AIDS Diag & Therapy Ctr, Warsaw, Poland

[10] Robert Koch Inst, D-1000 Berlin, Germany

[11] Statens Serum Inst, DK-2300 Copenhagen, Denmark

[12] Univ Athens, Sch Med, GR-11527 Athens, Greece

[13] Guys & St Thomas Hosp, London SE1 9RT, England

[14] Univ Vienna, Vienna, Austria

[15] IRSICAIXA Fdn, Retrovirol lab, Badalona, Spain

[16] Ctr Hosp Luxembourg, Luxembourg, Luxembourg

[17] Natl Publ Hlth Inst, Helsinki, Finland

[18] Karolinska Univ Hosp, Stockholm, Sweden

[19] Univ Belgrade, Sch Med, Minist Hlth, Belgrade, Serbia

来源：

AIDS | 2008年 / 22卷 / 05期

关键词：

Europe; HIV-1; resistance; transmission;

D O I：

10.1097/QAD.0b013e3282f5e062

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background: The spread of drug-resistant HIV-1 might compromise the future success of current first-line regimens. Objective: To analyse the extent and impact of transmission of drug-resistant HIV-1 variants in Europe. Design and methods: The European prospective programme (SPREAD) collected demographic, clinical and virological data from 1245 HIV-1 -infected individuals in 17 countries diagnosed in 2002-2003. The potential impact of transmitted drug resistance mutations (TDRMs) on therapy response was determined by using genotypic interpretation algorithms. Results: The overall prevalence of viruses with drug-resistance mutations was 9.1% [96/1050; 95% confidence interval: 7.5-11.1]. The majority (71 %) harboured only a single amino acid substitution with limited effect on predicted drug susceptibility. Mutations associated with resistance to nucleoside reverse transcriptase inhibitors were observed most frequently [57/1050 (5.4%)], followed by mutations related to protease inhibitors [32/1050 (3.0%)] and mutations related to non-nucleoside reverse transcriptase inhibitors (NNRTIs) [27/1050 (2.6%)]. In some cases, however, resistance was quite extensive. Four individuals were infected with viruses with reduced susceptibility to all nucleoside reverse transcriptase inhibitors, 3 to all protease inhibitors and 20 to both NNRTIs. Remarkably, in one individual, the resistance pattern was so extensive that none of the available current antiretroviral drugs was predicted to be fully active. Conclusion: The prevalence of TDRM-HIV is quite prominent (9.1%) but did not increase in comparison with a large retrospective European study. Particularly the presence of single NNRTI mutations may impact the efficacy of the first-line regimens. Continuous prospective monitoring remains indicated to explore the patterns and factors contributing to the transmission of TDRMs as well as the potential clinical consequences. (C) 2008 Wolters Kluwer Health Lippincott Williams & Wilkins

引用

页码：625 / 635

页数：11

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