Prevalence of Drug-Resistant HIV-1 Variants in Untreated Individuals in Europe: Implications for Clinical Management

Wensinq, Ann Emarie M. J.; Van De Vijver, David A.; Angarano, Gioacchino; Åsjö, Birgitta; Balotta, Claudia; Boeri, Enzo; Camacho, Ricardo; Chaix, Maire-Laure; Costagliola, Dominique; De Luca, Andrea; Derdelinckx, Inqe; Grossman, Zehava; Hamouda, Osamah; Hatzakis, Anqelos; Hemmer, Robert; Hoepelman, Andy; Horban, Andrzej; Korn, Klaus; Kücherer, Claudia; Leitner, Thomas
September 2005
Journal of Infectious Diseases;9/15/2005, Vol. 192 Issue 6, p958
Academic Journal
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 ⩾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.


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