1. Trends and predictors of transmitted drug resistance (TDR) and clusters with TDR in a local Belgian HIV-1 epidemic
- Author
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Pineda-Peña, A. -C, Schrooten, Y., Vinken, L., Ferreira, F., Li, G., Trovão, N. S., Khouri, R., Derdelinckx, I., De Munter, P., Kuc̈herer, C., Kostrikis, Leontios G., Nielsen, C., Littsola, K., Wensing, A., Stanojevic, M., Paredes, R., Balotta, Claudia, Albert, Jan, Boucher, C., Gomez-Lopez, A., Van Wijngaerden, E., Van Ranst, M., Vercauteren, J., Vandamme, A. M., Van Laethem, K., Kostrikis, Leontios G. [0000-0002-5340-7109], López-Galíndez, Cecilio, Erasmus MC other, and Virology
- Subjects
Male ,Epidemiology ,Human immunodeficiency virus type 1 subtype B ,Drug Resistance ,Human immunodeficiency virus 1 ,Proteinase Inhibitor ,Anti-Hiv Agents ,HIV Infections ,Men Who Have Sex With Men ,Men who have sex with men ,Immunodeficiency Viruses ,Belgium ,Pregnancy ,Salud pública ,Trend Study ,Medicine ,Epidemias ,Phylogeny ,education.field_of_study ,Health Survey ,3. Good health ,Transmitted Drug Resistance ,Medical Microbiology ,HIV epidemiology ,Viral Pathogens ,Cohort ,Infection ,Viral load ,Human ,medicine.medical_specialty ,Genotype ,Science ,HIV prevention ,Epidemic ,Microbial Sensitivity Tests ,Disease Surveillance ,Microbiology ,Article ,SDG 3 - Good Health and Well-being ,Genetics ,Humans ,Transmission ,Risk factor ,education ,Microbial Pathogens ,Retrospective Studies ,Aged ,Medicine and health sciences ,Preventive medicine ,Biology and Life Sciences ,Public and occupational health ,Immunology ,Virus 1 Infection ,HIV-1 ,Viral Diseases ,Anti Human Immunodeficiency Virus Agent ,Drug resistance ,1 Subtype B ,Risk Factors ,Prevalence ,Cluster Analysis ,Public Health Surveillance ,Virus Transmission ,Viral ,Univariate analysis ,Multidisciplinary ,Microbial Sensitivity Test ,Hiv Infections ,HIV diagnosis and management ,Middle Aged ,Infectious Diseases ,young adult ,Female ,Sequence Analysis ,Cohort Analysis ,Research Article ,Antiviral Resistance ,Adult ,Rna Directed Dna Polymerase Inhibitor ,Anti-HIV Agents ,Disease Association ,Population ,Major Clinical Study ,Drug Effects ,Resistencia a medicamentos ,Young Adult ,Retrospective Study ,Internal medicine ,Immunodeficiency Virus Type ,Virology ,Drug Resistance, Viral ,business.industry ,Risk Factor ,HIV ,Gender ,Human immunodeficiency virus 1 infection ,Confidence interval ,Diagnostic medicine ,Virus Load ,business ,Prediction - Abstract
We aimed to study epidemic trends and predictors for transmitted drug resistance (TDR) in our region, its clinical impact and its association with transmission clusters. We included 778 patients from the AIDS Reference Center in Leuven (Belgium) diagnosed from 1998 to 2012. Resistance testing was performed using population-based sequencing and TDR was estimated using the WHO-2009 surveillance list. Phylogenetic analysis was performed using maximum likelihood and Bayesian techniques. The cohort was predominantly Belgian (58.4%), men who have sex with men (MSM) (42.8%), and chronically infected (86.5%). The overall TDR prevalence was 9.6% (95% confidence interval (CI): 7.7-11.9), 6.5% (CI: 5.0-8.5) for nucleoside reverse transcriptase inhibitors (NRTI), 2.2% (CI: 1.4-3.5) for non-NRTI (NNRTI), and 2.2% (CI: 1.4-3.5) for protease inhibitors. A significant parabolic trend of NNRTI-TDR was found (p = 0.019). Factors significantly associated with TDR in univariate analysis were male gender, Belgian origin, MSM, recent infection, transmission clusters and subtype B, while multivariate and Bayesian network analysis singled out subtype B as the most predictive factor of TDR. Subtype B was related with transmission clusters with TDR that included 42.6% of the TDR patients. Thanks to resistance testing, 83% of the patients with TDR who started therapy had undetectable viral load whereas half of the patients would likely have received a suboptimal therapy without this test. In conclusion, TDR remained stable and a NNRTI up-and-down trend was observed. While the presence of clusters with TDR is worrying, we could not identify an independent, non-sequence based predictor for TDR or transmission clusters with TDR that could help with guidelines or public health measures. ispartof: PLoS One vol:9 issue:7 ispartof: location:United States status: published
- Published
- 2014