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. 2014 Apr 10;9(4):e94495.
doi: 10.1371/journal.pone.0094495. eCollection 2014.

Patterns of transmitted HIV drug resistance in Europe vary by risk group

Dineke Frentz  1 , David van de Vijver  1 , Ana Abecasis  2 , Jan Albert  3 , Osamah Hamouda  4 , Louise Jørgensen  5 , Claudia Kücherer  4 , Daniel Struck  6 , Jean-Claude Schmit  7 , Jurgen Vercauteren  8 , Birgitta Asjö  9 , Claudia Balotta  10 , Colm Bergin  11 , Danail Beshkov  12 , Ricardo Camacho  13 , Bonaventura Clotet  14 , Algirdas Griskevicius  15 , Zehava Grossman  16 , Andrzej Horban  17 , Tatjana Kolupajeva  18 , Klaus Korn  19 , Leondios Kostrikis  20 , Kirsi Liitsola Marek Linka  21 , Claus Nielsen  4 , Dan Otelea  22 , Dimitrios Paraskevis  23 , Roger Paredes  12 , Mario Poljak  24 , Elisabeth Puchhammer-Stöckl  25 , Anders Sönnerborg  26 , Danica Stanekova  27 , Maja Stanojevic  28 , Anne-Mieke Vandamme  8 , Charles Boucher  1 , Annemarie Wensing  29 ; SPREAD Programme
Collaborators, Affiliations

Patterns of transmitted HIV drug resistance in Europe vary by risk group

Dineke Frentz et al. PLoS One. .

Abstract

Background: In Europe, a continuous programme (SPREAD) has been in place for ten years to study transmission of drug resistant HIV. We analysed time trends of transmitted drug resistance mutations (TDRM) in relation to the risk behaviour reported.

Methods: HIV-1 patients newly diagnosed in 27 countries from 2002 through 2007 were included. Inclusion was representative for risk group and geographical distribution in the participating countries in Europe. Trends over time were calculated by logistic regression.

Results: From the 4317 patients included, the majority was men-having-sex-with-men -MSM (2084, 48%), followed by heterosexuals (1501, 35%) and injection drug users (IDU) (355, 8%). MSM were more often from Western Europe origin, infected with subtype B virus, and recently infected (<1 year) (p<0.001). The prevalence of TDRM was highest in MSM (prevalence of 11.1%), followed by heterosexuals (6.6%) and IDU (5.1%, p<0.001). TDRM was predominantly ascribed to nucleoside reverse transcriptase inhibitors (NRTI) with a prevalence of 6.6% in MSM, 3.3% in heterosexuals and 2.0% in IDU (p = 0.001). A significant increase in resistance to non- nucleoside reverse transcriptase inhibitors (NNRTIs) and a decrease in resistance to protease inhibitors was observed in MSM (p = 0.008 and p = 0.006, respectively), but not in heterosexual patients (p = 0.68 and p = 0.14, respectively).

Conclusions: MSM showed to have significantly higher TDRM prevalence compared to heterosexuals and IDU. The increasing NNRTI resistance in MSM is likely to negatively influence the therapy response of first-line therapy, as most include NNRTI drugs.

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Conflict of interest statement

Competing Interests: The co-author Dimitiros Paraskevis is indeed a PLOS ONE Editorial Board member. This does not alter the authors' adherence to PLOS ONE Editorial policies and criteria.

Figures

Figure 1
Figure 1. Prevalence of TDRM by drug classes in three risk groups.
Prevalences are shown of resistance to at least one of the drug classes (Any), nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI) and protease inhibitor (PI) in men who have sex with men (MSM), heterosexuals (HSX), and injection drug users (IDU). * = p<0.001 in comparison with MSM
Figure 2
Figure 2. Prevalence of TDRM in patients diagnosed from 2002 through 2007.
Prevalence of TDRM is shown for any of the drug classes (any class), nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI) and protease inhibitor (PI) in (A) Men having sex with men (MSM), and in (B) heterosexuals (HSX). The p-values of the time trends are shown on the right side of the graph.
See this image and copyright information in PMC

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