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J Infect Dis. 2005 Sep 15;192(6):958-66. Epub 2005 Aug 15.

Prevalence of drug-resistant HIV-1 variants in untreated individuals in Europe: implications for clinical management.

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1
Eijkman Winkler Institute, Department of Virology, University Medical Center Utrecht, The Netherlands.

Erratum in

  • J Infect Dis. 2005 Oct 15;192(8):1501.

Abstract

BACKGROUND:

Infection with drug-resistant human immunodeficiency virus type 1 (HIV-1) can impair the response to combination therapy. Widespread transmission of drug-resistant variants has the disturbing potential of limiting future therapy options and affecting the efficacy of postexposure prophylaxis.

METHODS:

We determined the baseline rate of drug resistance in 2208 therapy-naive patients recently and chronically infected with HIV-1 from 19 European countries during 1996-2002.

RESULTS:

In Europe, 1 of 10 antiretroviral-naive patients carried viruses with > or = 1 drug-resistance mutation. Recently infected patients harbored resistant variants more often than did chronically infected patients (13.5% vs. 8.7%; P=.006). Non-B viruses (30%) less frequently carried resistance mutations than did subtype B viruses (4.8% vs. 12.9%; P<.01). Baseline resistance increased over time in newly diagnosed cases of non-B infection: from 2.0% (1/49) in 1996-1998 to 8.2% (16/194) in 2000-2001.

CONCLUSIONS:

Drug-resistant variants are frequently present in both recently and chronically infected therapy-naive patients. Drug-resistant variants are most commonly seen in patients infected with subtype B virus, probably because of longer exposure of these viruses to drugs. However, an increase in baseline resistance in non-B viruses is observed. These data argue for testing all drug-naive patients and are of relevance when guidelines for management of postexposure prophylaxis and first-line therapy are updated.

PMID:
16107947
DOI:
10.1086/432916
[Indexed for MEDLINE]
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