Dynamics and phylogenetic relationships of HIV-1 transmitted drug resistance according to subtype in Italy over the years 2000-14

被引：15

作者：

Fabeni, L. ^{[1
]}

Alteri, C. ^{[2
]}

Di Carlo, D. ^{[2
]}

Orchi, N. ^{[1
]}

Carioti, L. ^{[2
]}

Bertoli, A. ^{[2
]}

Gori, C. ^{[1
]}

Forbici, F. ^{[1
]}

Continenza, F. ^{[1
]}

Maffongelli, G. ^{[3
]}

Pinnetti, C. ^{[1
]}

Vergori, A. ^{[1
]}

Mondi, A. ^{[1
]}

Ammassari, A. ^{[1
]}

Borghi, V. ^{[4
]}

Giuliani, M. ^{[5
]}

De Carli, G. ^{[1
]}

Pittalis, S. ^{[1
]}

Grisetti, S. ^{[1
]}

Pennica, A. ^{[6
]}

Mastroianni, C. M. ^{[7
]}

Montella, F. ^{[8
]}

Cristaudo, A. ^{[5
]}

Mussini, C. ^{[4
]}

Girardi, E. ^{[1
]}

Andreoni, M. ^{[3
]}

Antinori, A. ^{[1
]}

Ceccherini-Silberstein, F. ^{[2
]}

Perno, C. F. ^{[1
]}

Santoro, M. M. ^{[2
]}

机构：

[1] IRCCS, Natl Inst Infect Dis L Spallanzani, Rome, Italy

[2] Univ Roma Tor Vergata, Rome, Italy

[3] Univ Hosp Tor Vergata, Rome, Italy

[4] Modena Univ Hosp, Modena, Italy

[5] IRCCS, San Gallicano Dermatol Inst, Rome, Italy

[6] S Andrea Hosp, Rome, Italy

[7] Sapienza Univ, Latina, Italy

[8] S Giovanni Addolorata Hosp, Rome, Italy

来源：

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY | 2017年 / 72卷 / 10期

关键词：

ANTIRETROVIRAL TREATMENT; INFECTED PATIENTS; PREVALENCE; FRANCE; INDIVIDUALS; SURVEILLANCE; TRANSMISSION; DIVERSITY; INFERENCE; PATTERNS;

D O I：

10.1093/jac/dkx231

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: Transmitted drug-resistance (TDR) remains a critical aspect for the management of HIV-1-infected individuals. Thus, studying the dynamics of TDR is crucial to optimize HIV care. Methods: In total, 4323 HIV-1 protease/reverse-transcriptase sequences from drug-naive individuals diagnosed in north and central Italy between 2000 and 2014 were analysed. TDR was evaluated over time. Maximum-likelihood and Bayesian phylogenetic trees with bootstrap and Bayesian-probability supports defined transmission clusters. Results: Most individuals were males (80.2%) and Italian (72.1%), with a median (IQR) age of 37 (30-45) years. MSM accounted for 42.2% of cases, followed by heterosexuals (36.4%). Non-B subtype infections accounted for 30.8% of the overall population and increased over time (<2005-14: 19.5%-38.5%, P<0.0001), particularly among Italians (<2005-14: 6.5%-28.8%, P<0.0001). TDR prevalence was 8.8% and increased over time in non-B subtypes (<2005-14: 2%-7.1%, P=0.018). Overall, 467 transmission clusters (involving 1207 individuals; 27.9%) were identified. The prevalence of individuals grouping in transmission clusters increased over time in both B (<2005-14: 12.9%-33.5%, P=0.001) and non-B subtypes (<2005-14: 18.4%-41.9%, P=0.006). TDR transmission clusters were 13.3% within the overall cluster observed and dramatically increased in recent years (<2005-14: 14.3%-35.5%, P=0.005). This recent increase was mainly due to non-B subtype-infected individuals, who were also more frequently involved in large transmission clusters than those infected with a B subtype [median number of individuals in transmission clusters: 7 (IQR 6-19) versus 4 (3-4), P=0.047]. Conclusions: The epidemiology of HIV transmission changed greatly over time; the increasing number of transmission clusters (sometimes with drug resistance) shows that detection and proper treatment of the multitransmitters is a major target for controlling HIV spread.

引用

页码：2837 / 2845

页数：9

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