The impact of transmission clusters on primary drug resistance in newly diagnosed HIV-1 infection.
Détails
ID Serval
serval:BIB_9296A6893CB6
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
The impact of transmission clusters on primary drug resistance in newly diagnosed HIV-1 infection.
Périodique
Aids
Collaborateur⸱rice⸱s
Swiss HIV Cohort Study
Contributeur⸱rice⸱s
Aebi C., Battegay M., Bernasconi E., Böni J., Brazzola P., Bucher HC., Bürgisser P., Calmy A., Cattacin S., Cavassini M., Cheseaux JJ., Drack G., Dubs R., Egger M., Elzi L., Fischer M., Flepp M., Fontana A., Francioli P., Furrer HJ., Fux C., Gayet-Ageron A., Gerber S., Gorgievski M., Günthard H., Gyr T., Hirsch H., Hirschel B., Hösli I., Hüsler M., Kaiser L., Kahlert Ch., Karrer U., Kind C., Klimkait T., Ledergerber B., Martinetti G., Martinez B., Müller N., Nadal D., Paccaud F., Pantaleo G., Raio L., Rauch A., Regenass S., Rickenbach M., Rudin C., Schmid P., Schultze D., Schüpbach J., Speck R., Taffé P., Telenti A., Trkola A., Vernazza P., Weber R., Wyler CA., Yerly S.
ISSN
1473-5571 (Electronic)
ISSN-L
0269-9370
Statut éditorial
Publié
Date de publication
2009
Volume
23
Numéro
11
Pages
1415-1423
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
OBJECTIVES: To monitor HIV-1 transmitted drug resistance (TDR) in a well defined urban area with large access to antiretroviral therapy and to assess the potential source of infection of newly diagnosed HIV individuals.
METHODS: All individuals resident in Geneva, Switzerland, with a newly diagnosed HIV infection between 2000 and 2008 were screened for HIV resistance. An infection was considered as recent when the positive test followed a negative screening test within less than 1 year. Phylogenetic analyses were performed by using the maximum likelihood method on pol sequences including 1058 individuals with chronic infection living in Geneva.
RESULTS: Of 637 individuals with newly diagnosed HIV infection, 20% had a recent infection. Mutations associated with resistance to at least one drug class were detected in 8.5% [nucleoside reverse transcriptase inhibitors (NRTIs), 6.3%; non-nucleoside reverse transcriptase inhibitors (NNRTIs), 3.5%; protease inhibitors, 1.9%]. TDR (P-trend = 0.015) and, in particular, NNRTI resistance (P = 0.002) increased from 2000 to 2008. Phylogenetic analyses revealed that 34.9% of newly diagnosed individuals, and 52.7% of those with recent infection were linked to transmission clusters. Clusters were more frequent in individuals with TDR than in those with sensitive strains (59.3 vs. 32.6%, respectively; P < 0.0001). Moreover, 84% of newly diagnosed individuals with TDR were part of clusters composed of only newly diagnosed individuals.
CONCLUSION: Reconstruction of the HIV transmission networks using phylogenetic analysis shows that newly diagnosed HIV infections are a significant source of onward transmission, particularly of resistant strains, thus suggesting an important self-fueling mechanism for TDR.
METHODS: All individuals resident in Geneva, Switzerland, with a newly diagnosed HIV infection between 2000 and 2008 were screened for HIV resistance. An infection was considered as recent when the positive test followed a negative screening test within less than 1 year. Phylogenetic analyses were performed by using the maximum likelihood method on pol sequences including 1058 individuals with chronic infection living in Geneva.
RESULTS: Of 637 individuals with newly diagnosed HIV infection, 20% had a recent infection. Mutations associated with resistance to at least one drug class were detected in 8.5% [nucleoside reverse transcriptase inhibitors (NRTIs), 6.3%; non-nucleoside reverse transcriptase inhibitors (NNRTIs), 3.5%; protease inhibitors, 1.9%]. TDR (P-trend = 0.015) and, in particular, NNRTI resistance (P = 0.002) increased from 2000 to 2008. Phylogenetic analyses revealed that 34.9% of newly diagnosed individuals, and 52.7% of those with recent infection were linked to transmission clusters. Clusters were more frequent in individuals with TDR than in those with sensitive strains (59.3 vs. 32.6%, respectively; P < 0.0001). Moreover, 84% of newly diagnosed individuals with TDR were part of clusters composed of only newly diagnosed individuals.
CONCLUSION: Reconstruction of the HIV transmission networks using phylogenetic analysis shows that newly diagnosed HIV infections are a significant source of onward transmission, particularly of resistant strains, thus suggesting an important self-fueling mechanism for TDR.
Mots-clé
Adult, Drug Resistance, Viral/genetics, Epidemiologic Methods, Female, HIV Infections/genetics, HIV Infections/transmission, HIV-1, Humans, Male, Phylogeny
Pubmed
Web of science
Création de la notice
15/02/2010 12:05
Dernière modification de la notice
20/08/2019 15:55