Decreasing prevalence of transmitted drug resistance among ART-naive HIV-1-infected patients in Iceland, 1996-2012.

Q1 Environmental Science
Infection Ecology and Epidemiology Pub Date : 2017-06-13 eCollection Date: 2017-01-01 DOI:10.1080/20008686.2017.1328964
Malik Sallam, Gülşen Özkaya Şahin, Hlynur Indriðason, Joakim Esbjörnsson, Arthur Löve, Anders Widell, Magnus Gottfreðsson, Patrik Medstrand
{"title":"Decreasing prevalence of transmitted drug resistance among ART-naive HIV-1-infected patients in Iceland, 1996-2012.","authors":"Malik Sallam,&nbsp;Gülşen Özkaya Şahin,&nbsp;Hlynur Indriðason,&nbsp;Joakim Esbjörnsson,&nbsp;Arthur Löve,&nbsp;Anders Widell,&nbsp;Magnus Gottfreðsson,&nbsp;Patrik Medstrand","doi":"10.1080/20008686.2017.1328964","DOIUrl":null,"url":null,"abstract":"<p><p><b>Introduction:</b> Resistance to antiretroviral drugs can complicate the management of HIV-1 infection and impair control of its spread. The aim of the current study was to investigate the prevalence and transmission of HIV-1 drug resistance among 106 antiretroviral therapy (ART)-naïve patients diagnosed in Iceland (1996-2012). <b>Methods:</b> HIV-1 polymerase sequences were analysed using the Calibrated Population Resistance tool. Domestic spread of transmitted drug resistance (TDR) was investigated through maximum likelihood and Bayesian approaches. <b>Results:</b> Among ART-naïve patients, the prevalence of TDR to any of the following classes (NRTIs, NNRTIs and PIs) was 8.5% (95% CI: 4.5%- 15.4%): 6.6% to NRTIs, 0.9% to NNRTIs, and 1.9% to PIs. The most frequent NRTI mutation detected was T215C/D (n=7, 5.7%). The only NNRTI mutation detected was K103N (n=1, 0.9%). PI mutations detected were M46I (n=1, 0.9%) and L90M (n=1, 0.9%). Six patients harbouring T215C/D, were linked in a supported phylogenetic cluster. No significant association was found between TDR and demographic or risk groups. Trend analysis showed a decrease in the prevalence of TDR (1996-2012, p=0.003). <b>Conclusions:</b> TDR prevalence in Iceland was at a moderate level and decreased during 1996-2012. Screening for TDR is recommended to limit its local spread and to optimize HIV-1 therapy. <b>A</b><b>bbreviations</b>: ART: Anti-retroviral therapy; ARV: antiretroviral; ATV/r: atazanavir/ritonavir; AZT: azidothymidine; BEAST: Bayesian evolutionary analysis by sampling trees; CI: confidence interval; CPR: calibrated population resistance; CRF: circulating recombinant form; d4T: stavudine; EFV: efavirenz; FET: Fishers' exact test; FPV/r: fosamprenavir/ritonavir; HET: heterosexual; IDU: injection drug use; IDV/r: indinavir/ritonavir; LPV/r: lopinavir/ritonavir; MSM: men who have sex with men; M-W: Mann-Whitney <i>U</i> test; NFV: nelfinavir; NNRTIs: non-nucleoside reverse transcriptase inhibitors; NRTIs: nucleoside reverse transcriptase inhibitors; NVP: nevirapine; PIs: protease inhibitors; <i>pol</i>: polymerase gene; SDRM: surveillance drug resistance mutation; SQV/r: saquinavir/ritonavir; TDR: transmitted drug resistance.</p>","PeriodicalId":37446,"journal":{"name":"Infection Ecology and Epidemiology","volume":"7 1","pages":"1328964"},"PeriodicalIF":0.0000,"publicationDate":"2017-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20008686.2017.1328964","citationCount":"6","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection Ecology and Epidemiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/20008686.2017.1328964","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2017/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"Environmental Science","Score":null,"Total":0}
引用次数: 6

Abstract

Introduction: Resistance to antiretroviral drugs can complicate the management of HIV-1 infection and impair control of its spread. The aim of the current study was to investigate the prevalence and transmission of HIV-1 drug resistance among 106 antiretroviral therapy (ART)-naïve patients diagnosed in Iceland (1996-2012). Methods: HIV-1 polymerase sequences were analysed using the Calibrated Population Resistance tool. Domestic spread of transmitted drug resistance (TDR) was investigated through maximum likelihood and Bayesian approaches. Results: Among ART-naïve patients, the prevalence of TDR to any of the following classes (NRTIs, NNRTIs and PIs) was 8.5% (95% CI: 4.5%- 15.4%): 6.6% to NRTIs, 0.9% to NNRTIs, and 1.9% to PIs. The most frequent NRTI mutation detected was T215C/D (n=7, 5.7%). The only NNRTI mutation detected was K103N (n=1, 0.9%). PI mutations detected were M46I (n=1, 0.9%) and L90M (n=1, 0.9%). Six patients harbouring T215C/D, were linked in a supported phylogenetic cluster. No significant association was found between TDR and demographic or risk groups. Trend analysis showed a decrease in the prevalence of TDR (1996-2012, p=0.003). Conclusions: TDR prevalence in Iceland was at a moderate level and decreased during 1996-2012. Screening for TDR is recommended to limit its local spread and to optimize HIV-1 therapy. Abbreviations: ART: Anti-retroviral therapy; ARV: antiretroviral; ATV/r: atazanavir/ritonavir; AZT: azidothymidine; BEAST: Bayesian evolutionary analysis by sampling trees; CI: confidence interval; CPR: calibrated population resistance; CRF: circulating recombinant form; d4T: stavudine; EFV: efavirenz; FET: Fishers' exact test; FPV/r: fosamprenavir/ritonavir; HET: heterosexual; IDU: injection drug use; IDV/r: indinavir/ritonavir; LPV/r: lopinavir/ritonavir; MSM: men who have sex with men; M-W: Mann-Whitney U test; NFV: nelfinavir; NNRTIs: non-nucleoside reverse transcriptase inhibitors; NRTIs: nucleoside reverse transcriptase inhibitors; NVP: nevirapine; PIs: protease inhibitors; pol: polymerase gene; SDRM: surveillance drug resistance mutation; SQV/r: saquinavir/ritonavir; TDR: transmitted drug resistance.

Abstract Image

Abstract Image

1996-2012年冰岛初次接受抗逆转录病毒治疗的艾滋病毒-1感染患者中传播耐药性的流行率下降。
对抗逆转录病毒药物的耐药性会使HIV-1感染的管理复杂化,并损害对其传播的控制。本研究的目的是调查1996-2012年在冰岛诊断的106例抗逆转录病毒治疗(ART)-naïve患者中HIV-1耐药性的流行和传播情况。方法:使用校准的群体抗性工具对HIV-1聚合酶序列进行分析。采用最大似然法和贝叶斯法对国内传播性耐药(TDR)的传播情况进行了调查。结果:ART-naïve患者中,以下任何类别(nrti、nnrti和pi)的TDR患病率为8.5% (95% CI: 4.5%- 15.4%): nrti为6.6%,nnrti为0.9%,pi为1.9%。最常见的NRTI突变为T215C/D (n=7, 5.7%)。唯一检测到的NNRTI突变为K103N (n= 1,0.9%)。检测到PI突变为M46I (n=1, 0.9%)和L90M (n=1, 0.9%)。6例携带T215C/D的患者被联系在一个支持的系统发育集群中。TDR与人口统计学或危险人群之间没有发现显著关联。趋势分析显示TDR患病率下降(1996-2012,p=0.003)。结论:1996-2012年冰岛TDR患病率处于中等水平,呈下降趋势。建议筛查TDR以限制其局部传播并优化HIV-1治疗。缩写:ART:抗逆转录病毒治疗;抗逆转录病毒药物:抗逆转录病毒;ATV / r: atazanavir /例如;AZT:叠氮胸苷;BEAST:采样树贝叶斯进化分析;CI:置信区间;CPR:校准的种群抗性;CRF:循环重组形式;而:司他夫定;EFV:依法韦伦;费雪精确检验;废票/ r: fosamprenavir /例如;HET:异性恋;IDU:注射用药;价值/ r: indinavir /例如;LPV / r: lopinavir /例如;MSM:男男性行为者;曼-惠特尼U检验;NFV:奈非那韦;NNRTIs:非核苷类逆转录酶抑制剂;NRTIs:核苷逆转录酶抑制剂;一步法:奈韦拉平;PIs:蛋白酶抑制剂;聚合酶基因;SDRM:监测耐药突变;SQV / r: saquinavir /例如;TDR:传播性耐药性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Infection Ecology and Epidemiology
Infection Ecology and Epidemiology Environmental Science-Environmental Science (miscellaneous)
CiteScore
8.70
自引率
0.00%
发文量
4
审稿时长
12 weeks
期刊介绍: Infection Ecology & Epidemiology aims to stimulate inter-disciplinary collaborations dealing with a range of subjects, from the plethora of zoonotic infections in humans, over diseases with implication in wildlife ecology, to advanced virology and bacteriology. The journal specifically welcomes papers from studies where researchers from multiple medical and ecological disciplines are collaborating so as to increase our knowledge of the emergence, spread and effect of new and re-emerged infectious diseases in humans, domestic animals and wildlife. Main areas of interest include, but are not limited to: 1.Zoonotic microbioorganisms 2.Vector borne infections 3.Gastrointestinal pathogens 4.Antimicrobial resistance 5.Zoonotic microbioorganisms in changing environment
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信