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Medical News

Transmission of Drug-Resistant HIV-1 in Europe Remains Limited to Single Classes

April 11, 2008

The objective of the current study was to analyze the "extent and impact of transmission of drug-resistant HIV-1 variants in Europe."

The European prospective program (SPREAD) obtained demographic, clinical and virological data on 1,245 HIV-1-infected persons in 17 countries diagnosed between 2002 and 2003. Genotypic interpretation algorithms were used to determine the potential impact of transmitted drug resistance mutations (TDRMs) on therapy response.

Overall, 9.1 percent (96/1,050;95 percent confidence interval:7.5-11.1) of viruses had drug-resistance mutations. The majority (71 percent) harbored only a single amino acid substitution with limited effect on predicted drug susceptibility. Mutations associated with resistance to nucleoside reverse transcriptase inhibitors were observed most frequently [57/1,050 (5.4 percent)], followed by protease inhibitor-related mutations [32/1,050 (3.0 percent)] and mutations linked to non-nucleoside reverse transcriptase inhibitors (NNRTIs) [27/1,050 (2.6 percent)].

However, resistance was quite extensive in some cases. Four individuals were infected with viruses with reduced susceptibility to all nucleoside reverse transcriptase inhibitors, three to all protease inhibitors and 20 to both NNRTIs. In one individual, the resistance pattern was so extensive that none of currently available antiretroviral was predicted to be fully active.

"The prevalence of TDRM-HIV is quite prominent (9.1 percent) but did not increase in comparison with a large retrospective European study," the report concluded. "Particularly the presence of single NNRTI mutations may impact the efficacy of the first-line regimens. Continuous prospective monitoring remains indicated to explore the patterns and factors contributing to the transmission of TDRMs as well as the potential clinical consequences."

Back to other news for April 2008

Adapted from:
03.12.2008; Vol. 22; No. 5: P. 625-635; The SPREAD Program

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This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.
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