In:
HIV Medicine, Wiley, Vol. 18, No. 3 ( 2017-03), p. 204-213
Abstract:
Transmission of drug‐resistant HIV ‐1 has decreased in the UK since the early 2000s. This analysis reports recent trends and characteristics of transmitted drug resistance ( TDR ) in the UK from 2010 to 2013. Methods Resistance tests conducted in antiretroviral treatment ( ART )‐naïve individuals between 2010 and 2013 were analysed for the presence of transmitted drug resistance mutations ( TDRM s), defined as any mutations from a modified 2009 World Health Organization surveillance list, or a modified 2013 International Antiviral Society‐ USA list for integrase tests. Logistic regression was used to examine associations between demographics and the prevalence of TDRM s. Results TDRM s were observed in 1223 (7.5%) of 16 425 individuals; prevalence declined from 8.1% in 2010 to 6.6% in 2013 ( P = 0.02). The prevalence of TDRM s was higher among men who have sex with men ( MSM ) compared with heterosexual men and women (8.7% versus 6.4%, respectively) with a trend for decreasing TDRM s among MSM ( P = 0.008) driven by a reduction in nucleoside reverse transcriptase inhibitor ( NRTI )‐related mutations. The most frequently detected TDRM s were K103N (2.2%), T215 revertants (1.6%), M41L (0.9%) and L90M (0.7%). Predicted phenotypic resistance to first‐line ART was highest to the nonnucleoside reverse transcriptase inhibitors ( NNRTI s) rilpivirine and efavirenz (6.2% and 3.4%, respectively) but minimal to NRTI s, including tenofovir, and protease inhibitors ( PI s). No major integrase TDRM s were detected among 101 individuals tested while ART ‐naïve. Conclusions We observed a decrease in TDRM s in recent years. However, this was confined to the MSM population and rates remained stable in those with heterosexually acquired HIV infection. Resistance to currently recommended first‐line ART , including integrase inhibitors, remained reassuringly low.
Type of Medium:
Online Resource
ISSN:
1464-2662
,
1468-1293
DOI:
10.1111/hiv.2017.18.issue-3
Language:
English
Publisher:
Wiley
Publication Date:
2017
detail.hit.zdb_id:
2020341-X
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