BACKGROUND: There is an increasing prevalence of non-B subtype HIV type-1 (HIV-1) infections in Europe, reflecting patterns of migration. We examined the characteristics of HIV-1 drug resistance in antiretroviral treatment (ART)-naive individuals migrating to the UK. METHODS: Resistance tests reported to the UK HIV Drug Resistance Database between 2001 and 2006 were included. Demographic data were obtained via linkage to national databases. Resistance was defined as ≥ 1 drug resistance mutation. Non-B HIV-1 subtype was used as a surrogate marker of infection acquired outside the UK. Logistic regression was used to examine the association between demographics and the prevalence of resistance. RESULTS: Overall, 196/4,291 (4.6%) samples with non-B subtype showed resistance compared with 745/6,435 (11.6%) samples for subtype B. Among non-B subtypes, the prevalence of resistance decreased over time (6.0% in 2001-2003 to 3.2% in 2006) and was independently associated with later calendar year of sampling (P=0.001). Resistance was confined mainly to one ART class (85%); non-nucleoside reverse transcriptase inhibitor resistance was more common in subtype C (47%) compared with non-B non-C subtypes (29%; P=0.02). M184V was more common in non-B subtypes (non-B 30% versus B 5%; P<0.001) and T215 variants were more common in subtype B (non-B 10% versus B 49%; P<0.001). CONCLUSIONS: In ART-naive individuals living in the UK, but who are likely to have acquired HIV-1 abroad, we observed a downward trend in resistance over time, which is surprising in light of ART roll-out in resource-limited settings. Reassuringly, resistance was mainly confined to one drug class; however, patterns of resistance differed by subtype, with some evidence of possible undisclosed prior therapy in non-B subtypes.
BACKGROUND: There is an increasing prevalence of non-B subtype HIV type-1 (HIV-1) infections in Europe, reflecting patterns of migration. We examined the characteristics of HIV-1 drug resistance in antiretroviral treatment (ART)-naive individuals migrating to the UK. METHODS: Resistance tests reported to the UK HIV Drug Resistance Database between 2001 and 2006 were included. Demographic data were obtained via linkage to national databases. Resistance was defined as ≥ 1 drug resistance mutation. Non-B HIV-1 subtype was used as a surrogate marker of infection acquired outside the UK. Logistic regression was used to examine the association between demographics and the prevalence of resistance. RESULTS: Overall, 196/4,291 (4.6%) samples with non-B subtype showed resistance compared with 745/6,435 (11.6%) samples for subtype B. Among non-B subtypes, the prevalence of resistance decreased over time (6.0% in 2001-2003 to 3.2% in 2006) and was independently associated with later calendar year of sampling (P=0.001). Resistance was confined mainly to one ART class (85%); non-nucleoside reverse transcriptase inhibitor resistance was more common in subtype C (47%) compared with non-B non-C subtypes (29%; P=0.02). M184V was more common in non-B subtypes (non-B 30% versus B 5%; P<0.001) and T215 variants were more common in subtype B (non-B 10% versus B 49%; P<0.001). CONCLUSIONS: In ART-naive individuals living in the UK, but who are likely to have acquired HIV-1 abroad, we observed a downward trend in resistance over time, which is surprising in light of ART roll-out in resource-limited settings. Reassuringly, resistance was mainly confined to one drug class; however, patterns of resistance differed by subtype, with some evidence of possible undisclosed prior therapy in non-B subtypes.
Authors: Ivana Grgic; Snjezana Zidovec Lepej; Maja M Lunar; Mario Poljak; Adriana Vince; Ivana Baca Vrakela; Ana Planinic; Katja Seme; Josip Begovac Journal: AIDS Res Hum Retroviruses Date: 2012-10-04 Impact factor: 2.205
Authors: Gonzalo Yebra; Miguel de Mulder; María Jesús Pérez-Elías; José Antonio Pérez-Molina; Juan Carlos Galán; Jara Llenas-García; Santiago Moreno; África Holguín Journal: PLoS One Date: 2011-10-25 Impact factor: 3.240
Authors: Yolanda Vega; Elena Delgado; Aurora Fernández-García; Maria Teresa Cuevas; Michael M Thomson; Vanessa Montero; Monica Sánchez; Ana Maria Sánchez; Lucia Pérez-Álvarez Journal: PLoS One Date: 2015-05-26 Impact factor: 3.240
Authors: A Tostevin; E White; D Dunn; S Croxford; V Delpech; I Williams; D Asboe; A Pozniak; D Churchill; A M Geretti; D Pillay; C Sabin; A Leigh-Brown; E Smit Journal: HIV Med Date: 2016-08-01 Impact factor: 3.180
Authors: David Dolling; Caroline Sabin; Valerie Delpech; Erasmus Smit; Anton Pozniak; David Asboe; Andrew Leigh Brown; Duncan Churchill; Ian Williams; Anna Maria Geretti; Andrew Phillips; Nicola Mackie; Gary Murphy; Hannah Castro; Deenan Pillay; Patricia Cane; David Dunn; David Dolling Journal: BMJ Date: 2012-08-21