Increase in transmitted resistance to non-nucleoside reverse transcriptase inhibitors among newly diagnosed HIV-1 infections in Europe

Dineke Frentz, David van de Vijver, AB Abecasis, J (Jan) Albert, O Hamouda, LB Jorgensen, C Kucherer, D Struck, JC Schmit, J Vercauteren, B Asjo, C Balotta, D Beshkov, RJ Camacho, B Clotet, S Coughlan, A Griskevicius, Z Grossman, A Horban, T KolupajevaK Korn, LG Kostrikis, K Liitsola, M Linka, C Nielsen, D Otelea, D Paraskevis, R Paredes, M Poljak, E Puchhammer-Stockl, A Sonnerborg, D Stanekova, M Stanojevic, E van Wijngaerden, AMJ Wensing, Charles Boucher

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Background: One out of ten newly diagnosed patients in Europe was infected with a virus carrying a drug resistant mutation. We analysed the patterns over time for transmitted drug resistance mutations (wTDRM) using data from the European Spread program. Methods: Clinical, epidemiological and virological data from 4317 patients newly diagnosed with HIV-1 infection between 2002 and 2007 were analysed. Patients were enrolled using a pre-defined sampling strategy. Results: The overall prevalence of TDRM in this period was 8.9% (95% CI: 8.1-9.8). Interestingly, significant changes over time in TDRM caused by the different drug classes were found. Whereas nucleoside resistance mutations remained constant at 5%, a significant decline in protease inhibitors resistance mutations was observed, from 3.9% in 2002 to 1.6% in 2007 (p = 0.001). In contrast, resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) doubled from 2.0% in 2002 to 4.1% in 2007 (p = 0.004) with 58% of viral strains carrying a K103N mutation. Phylogenetic analysis showed that these temporal changes could not be explained by large clusters of TDRM. Conclusion: During the years 2002 to 2007 transmitted resistance to NNRTI has doubled to 4% in Europe. The frequent use of NNRTI in first-line regimens and the clinical impact of NNRTI mutations warrants continued monitoring.
Original languageUndefined/Unknown
JournalBMC Infectious Diseases
Publication statusPublished - 2014

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