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Increasing Prevalence of HIV-1 Transmitted Drug Resistance in Portugal: Implications for First Line Treatment Recommendations

Introduction: Treatment for All recommendations have allowed access to antiretroviral (ARV) treatment for an increasing number of patients. This minimizes the transmission of infection but can potentiate the risk of transmitted (TDR) and acquired drug resistance (ADR). Objective: To study the trends...

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Autores principales: Pingarilho, Marta, Pimentel, Victor, Diogo, Isabel, Fernandes, Sandra, Miranda, Mafalda, Pineda-Pena, Andrea, Libin, Pieter, Theys, Kristof, O. Martins, M. Rosário, Vandamme, Anne-Mieke, Camacho, Ricardo, Gomes, Perpétua, Abecasis, Ana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7693025/
https://www.ncbi.nlm.nih.gov/pubmed/33143301
http://dx.doi.org/10.3390/v12111238
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author Pingarilho, Marta
Pimentel, Victor
Diogo, Isabel
Fernandes, Sandra
Miranda, Mafalda
Pineda-Pena, Andrea
Libin, Pieter
Theys, Kristof
O. Martins, M. Rosário
Vandamme, Anne-Mieke
Camacho, Ricardo
Gomes, Perpétua
Abecasis, Ana
author_facet Pingarilho, Marta
Pimentel, Victor
Diogo, Isabel
Fernandes, Sandra
Miranda, Mafalda
Pineda-Pena, Andrea
Libin, Pieter
Theys, Kristof
O. Martins, M. Rosário
Vandamme, Anne-Mieke
Camacho, Ricardo
Gomes, Perpétua
Abecasis, Ana
author_sort Pingarilho, Marta
collection PubMed
description Introduction: Treatment for All recommendations have allowed access to antiretroviral (ARV) treatment for an increasing number of patients. This minimizes the transmission of infection but can potentiate the risk of transmitted (TDR) and acquired drug resistance (ADR). Objective: To study the trends of TDR and ADR in patients followed up in Portuguese hospitals between 2001 and 2017. Methods: In total, 11,911 patients of the Portuguese REGA database were included. TDR was defined as the presence of one or more surveillance drug resistance mutation according to the WHO surveillance list. Genotypic resistance to ARV was evaluated with Stanford HIVdb v7.0. Patterns of TDR, ADR and the prevalence of mutations over time were analyzed using logistic regression. Results and Discussion: The prevalence of TDR increased from 7.9% in 2003 to 13.1% in 2017 (p < 0.001). This was due to a significant increase in both resistance to nucleotide reverse transcriptase inhibitors (NRTIs) and non-nucleotide reverse transcriptase inhibitors (NNRTIs), from 5.6% to 6.7% (p = 0.002) and 2.9% to 8.9% (p < 0.001), respectively. TDR was associated with infection with subtype B, and with lower viral load levels (p < 0.05). The prevalence of ADR declined from 86.6% in 2001 to 51.0% in 2017 (p < 0.001), caused by decreasing drug resistance to all antiretroviral (ARV) classes (p < 0.001). Conclusions: While ADR has been decreasing since 2001, TDR has been increasing, reaching a value of 13.1% by the end of 2017. It is urgently necessary to develop public health programs to monitor the levels and patterns of TDR in newly diagnosed patients.
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spelling pubmed-76930252020-11-28 Increasing Prevalence of HIV-1 Transmitted Drug Resistance in Portugal: Implications for First Line Treatment Recommendations Pingarilho, Marta Pimentel, Victor Diogo, Isabel Fernandes, Sandra Miranda, Mafalda Pineda-Pena, Andrea Libin, Pieter Theys, Kristof O. Martins, M. Rosário Vandamme, Anne-Mieke Camacho, Ricardo Gomes, Perpétua Abecasis, Ana Viruses Article Introduction: Treatment for All recommendations have allowed access to antiretroviral (ARV) treatment for an increasing number of patients. This minimizes the transmission of infection but can potentiate the risk of transmitted (TDR) and acquired drug resistance (ADR). Objective: To study the trends of TDR and ADR in patients followed up in Portuguese hospitals between 2001 and 2017. Methods: In total, 11,911 patients of the Portuguese REGA database were included. TDR was defined as the presence of one or more surveillance drug resistance mutation according to the WHO surveillance list. Genotypic resistance to ARV was evaluated with Stanford HIVdb v7.0. Patterns of TDR, ADR and the prevalence of mutations over time were analyzed using logistic regression. Results and Discussion: The prevalence of TDR increased from 7.9% in 2003 to 13.1% in 2017 (p < 0.001). This was due to a significant increase in both resistance to nucleotide reverse transcriptase inhibitors (NRTIs) and non-nucleotide reverse transcriptase inhibitors (NNRTIs), from 5.6% to 6.7% (p = 0.002) and 2.9% to 8.9% (p < 0.001), respectively. TDR was associated with infection with subtype B, and with lower viral load levels (p < 0.05). The prevalence of ADR declined from 86.6% in 2001 to 51.0% in 2017 (p < 0.001), caused by decreasing drug resistance to all antiretroviral (ARV) classes (p < 0.001). Conclusions: While ADR has been decreasing since 2001, TDR has been increasing, reaching a value of 13.1% by the end of 2017. It is urgently necessary to develop public health programs to monitor the levels and patterns of TDR in newly diagnosed patients. MDPI 2020-10-30 /pmc/articles/PMC7693025/ /pubmed/33143301 http://dx.doi.org/10.3390/v12111238 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pingarilho, Marta
Pimentel, Victor
Diogo, Isabel
Fernandes, Sandra
Miranda, Mafalda
Pineda-Pena, Andrea
Libin, Pieter
Theys, Kristof
O. Martins, M. Rosário
Vandamme, Anne-Mieke
Camacho, Ricardo
Gomes, Perpétua
Abecasis, Ana
Increasing Prevalence of HIV-1 Transmitted Drug Resistance in Portugal: Implications for First Line Treatment Recommendations
title Increasing Prevalence of HIV-1 Transmitted Drug Resistance in Portugal: Implications for First Line Treatment Recommendations
title_full Increasing Prevalence of HIV-1 Transmitted Drug Resistance in Portugal: Implications for First Line Treatment Recommendations
title_fullStr Increasing Prevalence of HIV-1 Transmitted Drug Resistance in Portugal: Implications for First Line Treatment Recommendations
title_full_unstemmed Increasing Prevalence of HIV-1 Transmitted Drug Resistance in Portugal: Implications for First Line Treatment Recommendations
title_short Increasing Prevalence of HIV-1 Transmitted Drug Resistance in Portugal: Implications for First Line Treatment Recommendations
title_sort increasing prevalence of hiv-1 transmitted drug resistance in portugal: implications for first line treatment recommendations
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7693025/
https://www.ncbi.nlm.nih.gov/pubmed/33143301
http://dx.doi.org/10.3390/v12111238
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