OBJECTIVES: A major barrier to successful viral suppression in HIV type 1 (HIV-1)-infected individuals is the emergence of virus resistant to antiretroviral drugs. We explored the evolution of genotypic drug resistance prevalence in treatment-failing patients from 1999 to 2005 in a clinical cohort. PATIENTS AND METHODS: Prevalence of major International AIDS Society-USA HIV-1 drug resistance mutations was measured over calendar years in a population with treatment failure and undergoing resistance testing. Predictors of the presence of resistance mutations were analysed by logistic regression. RESULTS: Significant reductions of the prevalence of resistance to all three drug classes examined were observed. This was accompanied by a reduction in the proportion of treatment-failing patients. Independent predictors of drug resistance were the earlier calendar year, prior use of suboptimal nucleoside analogue therapy, male sex and higher CD4 levels at testing. CONCLUSIONS: In a single clinical cohort, we observed a decrease in the prevalence of resistance to all three examined antiretroviral drug classes over time. If this finding is confirmed in multicentre cohorts it may translate into reduced transmission of drug-resistant virus from treated patients.
OBJECTIVES: A major barrier to successful viral suppression in HIV type 1 (HIV-1)-infected individuals is the emergence of virus resistant to antiretroviral drugs. We explored the evolution of genotypic drug resistance prevalence in treatment-failing patients from 1999 to 2005 in a clinical cohort. PATIENTS AND METHODS: Prevalence of major International AIDS Society-USA HIV-1 drug resistance mutations was measured over calendar years in a population with treatment failure and undergoing resistance testing. Predictors of the presence of resistance mutations were analysed by logistic regression. RESULTS: Significant reductions of the prevalence of resistance to all three drug classes examined were observed. This was accompanied by a reduction in the proportion of treatment-failing patients. Independent predictors of drug resistance were the earlier calendar year, prior use of suboptimal nucleoside analogue therapy, male sex and higher CD4 levels at testing. CONCLUSIONS: In a single clinical cohort, we observed a decrease in the prevalence of resistance to all three examined antiretroviral drug classes over time. If this finding is confirmed in multicentre cohorts it may translate into reduced transmission of drug-resistant virus from treated patients.
Authors: Alison G Abraham; Bryan Lau; Steven Deeks; Richard D Moore; Jinbing Zhang; Joseph Eron; Richard Harrigan; M John Gill; Mari Kitahata; Marina Klein; Sonia Napravnik; Anita Rachlis; Benigno Rodriguez; Sean Rourke; Constance Benson; Ron Bosch; Ann Collier; Kelly Gebo; James Goedert; Robert Hogg; Michael Horberg; Lisa Jacobson; Amy Justice; Greg Kirk; Jeff Martin; Rosemary McKaig; Michael Silverberg; Timothy Sterling; Jennifer Thorne; James Willig; Stephen J Gange Journal: Am J Epidemiol Date: 2011-08-03 Impact factor: 4.897
Authors: Mattia C F Prosperi; Simona Di Giambenedetto; Iuri Fanti; Genny Meini; Bianca Bruzzone; Annapaola Callegaro; Giovanni Penco; Patrizia Bagnarelli; Valeria Micheli; Elisabetta Paolini; Antonio Di Biagio; Valeria Ghisetti; Massimo Di Pietro; Maurizio Zazzi; Andrea De Luca Journal: BMC Med Inform Decis Mak Date: 2011-06-14 Impact factor: 2.796