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Tostevin, A, White, E, Dunn, D, Croxford, S, Delpech, V, Williams, I, Asboe, D, Pozniak, A, Churchill, D, Geretti, A M, Pillay, D, Sabin, C, Leigh-Brown, A and Smit, E (2017) Recent trends and patterns in HIV-1 transmitted drug resistance in the United Kingdom. HIV medicine, 18 (3). pp. 204-213. ISSN 1468-1293. This article is available to all HEFT staff and students via ASK HEFT Discovery tool http://tinyurl.com/z795c8c using their HEFT Athens Login.
Full text not available from this repository.Abstract
OBJECTIVES
Transmission of drug-resistant HIV-1 has decreased in the UK since the early 2000s. This analysis reports recent trends and characteristics of transmitted drug resistance (TDR) in the UK from 2010 to 2013.
METHODS
Resistance tests conducted in antiretroviral treatment (ART)-naïve individuals between 2010 and 2013 were analysed for the presence of transmitted drug resistance mutations (TDRMs), defined as any mutations from a modified 2009 World Health Organization surveillance list, or a modified 2013 International Antiviral Society-USA list for integrase tests. Logistic regression was used to examine associations between demographics and the prevalence of TDRMs.
RESULTS
TDRMs were observed in 1223 (7.5%) of 16 425 individuals; prevalence declined from 8.1% in 2010 to 6.6% in 2013 (P = 0.02). The prevalence of TDRMs was higher among men who have sex with men (MSM) compared with heterosexual men and women (8.7% versus 6.4%, respectively) with a trend for decreasing TDRMs among MSM (P = 0.008) driven by a reduction in nucleoside reverse transcriptase inhibitor (NRTI)-related mutations. The most frequently detected TDRMs were K103N (2.2%), T215 revertants (1.6%), M41L (0.9%) and L90M (0.7%). Predicted phenotypic resistance to first-line ART was highest to the nonnucleoside reverse transcriptase inhibitors (NNRTIs) rilpivirine and efavirenz (6.2% and 3.4%, respectively) but minimal to NRTIs, including tenofovir, and protease inhibitors (PIs). No major integrase TDRMs were detected among 101 individuals tested while ART-naïve.
CONCLUSIONS
We observed a decrease in TDRMs in recent years. However, this was confined to the MSM population and rates remained stable in those with heterosexually acquired HIV infection. Resistance to currently recommended first-line ART, including integrase inhibitors, remained reassuringly low.
| Item Type: | Article |
|---|---|
| Additional Information: | This article is available to all HEFT staff and students via ASK HEFT Discovery tool http://tinyurl.com/z795c8c using their HEFT Athens Login. |
| Subjects: | WC Communicabable diseases |
| Divisions: | Clinical Support > Infectious Diseases |
| Related URLs: | |
| Depositing User: | Mr Philip O'Reilly |
| Date Deposited: | 23 Nov 2017 16:37 |
| Last Modified: | 23 Nov 2017 16:37 |
| URI: | http://www.repository.uhblibrary.co.uk/id/eprint/1493 |
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