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Prevalence and trends in transmitted and acquired antiretroviral drug resistance, Washington, DC, 1999–2014

BACKGROUND: Drug resistance limits options for antiretroviral therapy (ART) and results in poorer health outcomes among HIV-infected persons. We sought to characterize resistance patterns and to identify predictors of resistance in Washington, DC. METHODS: We analyzed resistance in the DC Cohort, a...

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Autores principales: Aldous, Annette M., Castel, Amanda D., Parenti, David M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594524/
https://www.ncbi.nlm.nih.gov/pubmed/28893321
http://dx.doi.org/10.1186/s13104-017-2764-9
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author Aldous, Annette M.
Castel, Amanda D.
Parenti, David M.
author_facet Aldous, Annette M.
Castel, Amanda D.
Parenti, David M.
author_sort Aldous, Annette M.
collection PubMed
description BACKGROUND: Drug resistance limits options for antiretroviral therapy (ART) and results in poorer health outcomes among HIV-infected persons. We sought to characterize resistance patterns and to identify predictors of resistance in Washington, DC. METHODS: We analyzed resistance in the DC Cohort, a longitudinal study of HIV-infected persons in care in Washington, DC. We measured cumulative drug resistance (CDR) among participants with any genotype between 1999 and 2014 (n = 3411), transmitted drug resistance (TDR) in ART-naïve persons (n = 1503), and acquired drug resistance (ADR) in persons with genotypes before and after ART initiation (n = 309). Using logistic regression, we assessed associations between patient characteristics and transmitted resistance to any antiretroviral. RESULTS: Prevalence of TDR was 20.5%, of ADR 40.5%, and of CDR 45.1% in the respective analysis groups. From 2004 to 2013, TDR prevalence decreased for nucleoside and nucleotide analogue reverse transcriptase inhibitors (15.0 to 5.5%; p = 0.0003) and increased for integrase strand transfer inhibitors (INSTIs) (0.0–1.4%; p = 0.04). In multivariable analysis, TDR was not associated with age, race/ethnicity, HIV risk group, or years from HIV diagnosis. CONCLUSIONS: In this urban cohort of HIV-infected persons, almost half of participants tested had evidence of CDR; and resistance to INSTIs was increasing. If this trend continues, inclusion of the integrase-encoding region in baseline genotype testing should be strongly considered.
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spelling pubmed-55945242017-09-14 Prevalence and trends in transmitted and acquired antiretroviral drug resistance, Washington, DC, 1999–2014 Aldous, Annette M. Castel, Amanda D. Parenti, David M. BMC Res Notes Research Article BACKGROUND: Drug resistance limits options for antiretroviral therapy (ART) and results in poorer health outcomes among HIV-infected persons. We sought to characterize resistance patterns and to identify predictors of resistance in Washington, DC. METHODS: We analyzed resistance in the DC Cohort, a longitudinal study of HIV-infected persons in care in Washington, DC. We measured cumulative drug resistance (CDR) among participants with any genotype between 1999 and 2014 (n = 3411), transmitted drug resistance (TDR) in ART-naïve persons (n = 1503), and acquired drug resistance (ADR) in persons with genotypes before and after ART initiation (n = 309). Using logistic regression, we assessed associations between patient characteristics and transmitted resistance to any antiretroviral. RESULTS: Prevalence of TDR was 20.5%, of ADR 40.5%, and of CDR 45.1% in the respective analysis groups. From 2004 to 2013, TDR prevalence decreased for nucleoside and nucleotide analogue reverse transcriptase inhibitors (15.0 to 5.5%; p = 0.0003) and increased for integrase strand transfer inhibitors (INSTIs) (0.0–1.4%; p = 0.04). In multivariable analysis, TDR was not associated with age, race/ethnicity, HIV risk group, or years from HIV diagnosis. CONCLUSIONS: In this urban cohort of HIV-infected persons, almost half of participants tested had evidence of CDR; and resistance to INSTIs was increasing. If this trend continues, inclusion of the integrase-encoding region in baseline genotype testing should be strongly considered. BioMed Central 2017-09-11 /pmc/articles/PMC5594524/ /pubmed/28893321 http://dx.doi.org/10.1186/s13104-017-2764-9 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Aldous, Annette M.
Castel, Amanda D.
Parenti, David M.
Prevalence and trends in transmitted and acquired antiretroviral drug resistance, Washington, DC, 1999–2014
title Prevalence and trends in transmitted and acquired antiretroviral drug resistance, Washington, DC, 1999–2014
title_full Prevalence and trends in transmitted and acquired antiretroviral drug resistance, Washington, DC, 1999–2014
title_fullStr Prevalence and trends in transmitted and acquired antiretroviral drug resistance, Washington, DC, 1999–2014
title_full_unstemmed Prevalence and trends in transmitted and acquired antiretroviral drug resistance, Washington, DC, 1999–2014
title_short Prevalence and trends in transmitted and acquired antiretroviral drug resistance, Washington, DC, 1999–2014
title_sort prevalence and trends in transmitted and acquired antiretroviral drug resistance, washington, dc, 1999–2014
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594524/
https://www.ncbi.nlm.nih.gov/pubmed/28893321
http://dx.doi.org/10.1186/s13104-017-2764-9
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