BACKGROUND: Infection 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. METHODS: We 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. RESULTS: In Europe, 1 of 10 antiretroviral-naive patients carried viruses with > or = 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. CONCLUSIONS: Drug-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.
BACKGROUND: Infection 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. METHODS: We 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. RESULTS: In Europe, 1 of 10 antiretroviral-naive patients carried viruses with > or = 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. CONCLUSIONS: Drug-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.
Authors: Gonzalo Yebra; Miguel de Mulder; Leticia Martín; Carmen Rodríguez; Pablo Labarga; Isabel Viciana; Juan Berenguer; María Remedios Alemán; Juan Antonio Pineda; Federico García; Africa Holguín Journal: J Clin Microbiol Date: 2011-12-07 Impact factor: 5.948
Authors: Robert W Shafer; Soo-Yon Rhee; Deenan Pillay; Veronica Miller; Paul Sandstrom; Jonathan M Schapiro; Daniel R Kuritzkes; Diane Bennett Journal: AIDS Date: 2007-01-11 Impact factor: 4.177
Authors: Matt A Price; Carole L Wallis; Shabir Lakhi; Etienne Karita; Anatoli Kamali; Omu Anzala; Eduard J Sanders; Linda-Gail Bekker; Rogers Twesigye; Eric Hunter; Pontiano Kaleebu; Kayitesi Kayitenkore; Susan Allen; Eugene Ruzagira; Mary Mwangome; Gaudensia Mutua; Pauli N Amornkul; Gwynn Stevens; Sergei L K Pond; Malinda Schaefer; Mary A Papathanasopoulos; Wendy Stevens; Jill Gilmour Journal: AIDS Res Hum Retroviruses Date: 2010-11-23 Impact factor: 2.205