Acute HIV infection: impact on the spread of HIV and transmission of drug resistance

Détails

ID Serval
serval:BIB_8D07CE5B4193
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Acute HIV infection: impact on the spread of HIV and transmission of drug resistance
Périodique
AIDS
Auteur(s)
Yerly  S., Vora  S., Rizzardi  P., Chave  J. P., Vernazza  P. L., Flepp  M., Telenti  A., Battegay  M., Veuthey  A. L., Bru  J. P., Rickenbach  M., Hirschel  B., Perrin  L.
ISSN
0269-9370 (Print)
Statut éditorial
Publié
Date de publication
11/2001
Volume
15
Numéro
17
Pages
2287-92
Notes
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't --- Old month value: Nov 23
Résumé
OBJECTIVE: To assess the impact of primary HIV infection (PHI) on the spread of HIV and the temporal trends in transmission of HIV drug resistance between 1996 and 1999 in Switzerland. METHODS: Sequencing of the genes for reverse transcriptase (RT) and protease was performed for 197 individuals with documented PHI. Phylogenetic analyses were confronted with epidemiological data. RESULTS: Significant clustering was demonstrated for 29% of the RT sequences. All these cases occurred closely together in place and time; contact tracing demonstrated transmission at the time of PHI in 30% of them. Genotypic drug resistance was detected in 8.6% of PHI individuals in 1996, 14.6% in 1997, 8.8% in 1998 and 5.0% in 1999. Drug-resistant variants were identified in 11.3% of individuals infected by homosexual contacts, 6.1% by heterosexual contacts, 13% of intravenous drug users and more frequently in men (10.4%) than women (2.6%). Potential factors involved in the recent decrease of transmission of drug-resistant variants include increase of HIV non-B subtypes from 23% in 1996 to 35% in 1999 (only one non-B subtype had resistance mutations) and a steady increase of patients with undetectable viraemia as documented in Swiss HIV Cohort Study (10% in 1996 vs 53% in 1999). CONCLUSIONS: Phylogenetic and epidemiological analyses underline the impact of PHI in the spread of HIV. Moreover, this study indicates that drug resistance transmission may have decreased recently in Switzerland through the increased frequency of infection with HIV non-B subtypes and the steady increase of patients with undetectable viraemia.
Mots-clé
Acute Disease Adolescent Adult Aged *Drug Resistance, Viral/genetics Female HIV Infections/epidemiology/immunology/*transmission/virology HIV Protease/genetics HIV-1/classification/*drug effects/enzymology/genetics HIV-1 Reverse Transcriptase/genetics Humans Male Middle Aged Phylogeny Switzerland/epidemiology Variation (Genetics)
Pubmed
Web of science
Création de la notice
29/01/2008 9:52
Dernière modification de la notice
03/03/2018 19:15
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