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%;). Baseline resistance increased over time in newly diagnosed cases of non-B infection: from P <.01 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.
Prevalence of drug-resistant HIV-1 variants in untreated individuals in Europe : Implications for clinical management / A.M. Wensing, D.A. van de Vijver, G. Angarano, B. Asjo, C. Balotta, E. Boeri, R. Camacho, M.L. Chaix, D. Costagliola, A. De Luca, I. Derdelinckx, Z. Grossman, O. Hamouda, A. Hatzakis, R. Hemmer, A. Hoepelman, A. Horban, K. Korn, C. Kucherer, T. Leitner, C. - In: THE JOURNAL OF INFECTIOUS DISEASES. - ISSN 0022-1899. - 192:6(2005), pp. 958-966.
|Titolo:||Prevalence of drug-resistant HIV-1 variants in untreated individuals in Europe : Implications for clinical management|
|Settore Scientifico Disciplinare:||Settore MED/17 - Malattie Infettive|
|Data di pubblicazione:||2005|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1086/432916|
|Appare nelle tipologie:||01 - Articolo su periodico|