Olson, A;
Bannert, N;
Soennerborg, A;
de Mendoza, C;
Price, M;
Zangerle, R;
Chaix, M-L;
... Porter, K; + view all
(2018)
Temporal trends of transmitted HIV drug resistance in a multinational seroconversion cohort.
AIDS
, 32
(2)
pp. 161-169.
10.1097/QAD.0000000000001689.
Preview |
Text
Porter_2017_09_07_DR_manuscript.pdf - Accepted Version Download (459kB) | Preview |
Abstract
BACKGROUND: The rate of transmitted drug resistance (TDR) may increase with wider use of antiretroviral therapy and can contribute to therapeutic failure. We analysed time trends in TDR among HIV seroconverters. METHODS: Using CASCADE data of individuals with well estimated dates of HIV seroconversion, we examined HIV nucleotide sequences collected prior to antiretroviral therapy use from 1996–2012. All samples were taken within 12 months of testing HIV positive. Using logistic regression, we examined the association between TDR and year of seroconversion, adjusting for confounders. RESULTS: Of 4717 individuals seroconverting between 1996 and 2012, median (IQR) age at seroconversion was 33 (27, 39) years. The majority (3839; 92%) were male, mainly exposed through MSM (3767; 80%), and infected with subtype B (3464; 73%). Overall, 515 (11%) individuals had at least one drug resistance-related mutation; 280 individuals with nucleoside reverse transcriptase, 185 with nonnucleoside reverse transcriptase, and 144 with protease inhibitor mutations. Estimated TDR prevalence was 19.4% (8.2, 36.0) in 1996, significantly decreasing to 8.5% (5.9, 11.9) in 2012 [odds ratio (OR; 95% confidence interval (CI)) = 0.92 (0.90, 0.95) per year increase]. Individuals exposed through sex between men and women were significantly less likely to have been infected with a drug-resistant strain [OR (95% CI) = 0.59 (0.41, 0.87) compared with MSM], and there was marginal evidence that sampling during acute infection was associated with higher odds of resistance [OR (95% CI) = 1.20 (0.97, 1.7), P = 0.093] compared with later sampling. CONCLUSIONS: TDR has decreased over calendar time although a significant proportion of new infections still carry resistance-related mutations.
| Type: | Article |
|---|---|
| Title: | Temporal trends of transmitted HIV drug resistance in a multinational seroconversion cohort |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/QAD.0000000000001689 |
| Publisher version: | http://dx.doi.org/10.1097/QAD.0000000000001689 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Immunology, Infectious Diseases, Virology, HIV drug resistance, HIV seroconverters, temporal trends, time trends, Immunodeficiency-Virus-Infection, Antiretroviral Therapy, Virological Outcomes, Inhibitor Therapy, United-Kingdom, Adherence, Prevalence, Transmission, Mutations, Adults |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10042629 |
Archive Staff Only
 |
View Item |
