BACKGROUND: Antiretroviral therapy has dramatically reduced the morbidity and mortality of infection due to HIV. The emergence of drug-resistant virus has limited the usefulness of many drugs. OBJECTIVE: To determine the prevalence of HIV drug resistance in the population of adults receiving care in the United States. DESIGN AND METHODS: HIV drug susceptibility assays were performed on plasma virus from a random sample representative of the 132500 HIV-infected American adults who had received medical care in early 1996 yet were viremic with > 500 copies/ml of HIV RNA in late 1998. A blood sample was obtained from 1797 patients who comprised a representative sample of the 208900 adults receiving urban care for HIV infection in early 1996 who survived to late 1998. The sampling procedure permitted weighting each evaluated patient to reflect demographic and other characteristics of the target population. RESULTS: We estimated that 132500 (63%) of the target population had HIV viremia of > 500 copies/ml. Among viremic patients, an estimated 76% had resistance to one or more antiretroviral drugs. The odds of resistance were significantly higher in patients with a history of antiretroviral drug use, advanced HIV disease, higher plasma HIV viral load and lowest CD4 cell count by self-report. CONCLUSIONS: The frequent selection for drug-resistant virus among viremic patients during the first 3 years of widespread use of potent antiretroviral combination therapy has significant implications for HIV treatment and transmission.
BACKGROUND: Antiretroviral therapy has dramatically reduced the morbidity and mortality of infection due to HIV. The emergence of drug-resistant virus has limited the usefulness of many drugs. OBJECTIVE: To determine the prevalence of HIV drug resistance in the population of adults receiving care in the United States. DESIGN AND METHODS: HIV drug susceptibility assays were performed on plasma virus from a random sample representative of the 132500 HIV-infected American adults who had received medical care in early 1996 yet were viremic with > 500 copies/ml of HIV RNA in late 1998. A blood sample was obtained from 1797 patients who comprised a representative sample of the 208900 adults receiving urban care for HIV infection in early 1996 who survived to late 1998. The sampling procedure permitted weighting each evaluated patient to reflect demographic and other characteristics of the target population. RESULTS: We estimated that 132500 (63%) of the target population had HIV viremia of > 500 copies/ml. Among viremic patients, an estimated 76% had resistance to one or more antiretroviral drugs. The odds of resistance were significantly higher in patients with a history of antiretroviral drug use, advanced HIV disease, higher plasma HIV viral load and lowest CD4 cell count by self-report. CONCLUSIONS: The frequent selection for drug-resistant virus among viremic patients during the first 3 years of widespread use of potent antiretroviral combination therapy has significant implications for HIV treatment and transmission.
Authors: Kimdar S Kemal; Christina M Ramirez; Harold Burger; Brian Foley; Douglas Mayers; Thomas Klimkait; François Hamy; Kathryn Anastos; Katarina Petrovic; Vladimir N Minin; Marc A Suchard; Barbara Weiser Journal: AIDS Res Hum Retroviruses Date: 2012-04-10 Impact factor: 2.205
Authors: Anton L Pozniak; Marta Boffito; Deborah Russell; Caroline E Ridgway; Gary J Muirhead Journal: Br J Clin Pharmacol Date: 2008-04 Impact factor: 4.335
Authors: David E Martin; Robert Blum; John Wilton; Judy Doto; Hal Galbraith; Gina L Burgess; Philip C Smith; Charles Ballow Journal: Antimicrob Agents Chemother Date: 2007-06-18 Impact factor: 5.191
Authors: Vikram S Gill; Viviane D Lima; Wen Zhang; Brian Wynhoven; Benita Yip; Robert S Hogg; Julio S G Montaner; P Richard Harrigan Journal: Clin Infect Dis Date: 2010-01-01 Impact factor: 9.079