1. Transmission Dynamics of HIV-1 Drug Resistance among Treatment-Naïve Individuals in Greece: The Added Value of Molecular Epidemiology to Public Health
- Author
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Dimitrios Paraskevis, Panagiotis Gargalianos, Sofia Kourkounti, Helen Sambatakou, Stylianos Drimis, Angelos Hatzakis, Malvina Lada, Vasileios Papastamopoulos, Periklis Panagopoulos, Dimitra Paraskeva, Maria Chini, Efstratios Maltezos, Nikolaos V. Sipsas, Mina Psichogiou, Evangelia Georgia Kostaki, Vasileios Paparizos, Antonios Papadopoulos, Georgios Daikos, Georgios Chrysos, Anastasia Antoniadou, Marios Lazanas, Georgios Xylomenos, and Athanasios Skoutelis
- Subjects
0301 basic medicine ,medicine.medical_specialty ,lcsh:QH426-470 ,Human immunodeficiency virus (HIV) ,Drug resistance ,Biology ,medicine.disease_cause ,molecular epidemiology ,Article ,law.invention ,Therapy naive ,03 medical and health sciences ,law ,Genetics ,medicine ,Genetics (clinical) ,drug resistance ,Molecular epidemiology ,Public health ,virus diseases ,HIV ,Virology ,Virological failure ,3. Good health ,lcsh:Genetics ,030104 developmental biology ,Transmission (mechanics) ,transmission dynamics ,effective reproductive number ,Demography - Abstract
The presence of human immunodeficiency virus type 1 (HIV-1) drug resistance among drug-naïve patients remains stable, although the proportion of patients with virological failure to therapy is decreasing. The dynamics of transmitted resistance among drug-naïve patients remains largely unknown. The prevalence of non-nucleoside reverse transcriptase inhibitors (NNRTI) resistance was 16.9% among treatment-naïve individuals in Greece. We aimed to investigate the transmission dynamics and the effective reproductive number (Re) of the locally transmitted NNRTI resistance. We analyzed sequences with dominant NNRTI resistance mutations (E138A and K103N) found within monophyletic clusters (local transmission networks (LTNs)) from patients in Greece. For the K103N LTN, the Re was >1 between 2008 and the first half of 2013. For all E138A LTNs, the Re was >1 between 1998 and 2015, except the most recent one (E138A_4), where the Re was >1 between 2006 and 2011 and approximately equal to 1 thereafter. K103N and E138A_4 showed similar characteristics with a more recent origin, higher Re during the first years of the sub-epidemics, and a declining trend in the number of transmissions during the last two years. In the remaining LTNs the epidemic was still expanding. Our study highlights the added value of molecular epidemiology to public health.
- Published
- 2017