Recent trends and patterns in HIV-1 transmitted drug resistance in the United Kingdom


Tostevin, A, White, E, Dunn, D, Croxford, S, Delpech, V, Williams, I, Asboe, D, Pozniak, A, Churchill, D, Geretti, AM ORCID: 0000-0002-3670-6588 et al (show 4 more authors) (2017) Recent trends and patterns in HIV-1 transmitted drug resistance in the United Kingdom. HIV MEDICINE, 18 (3). pp. 204-213.

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Abstract

<h4>Objectives</h4>Transmission of drug-resistant HIV-1 has decreased in the UK since the early 2000s. This analysis reports recent trends and characteristics of transmitted drug resistance (TDR) in the UK from 2010 to 2013.<h4>Methods</h4>Resistance tests conducted in antiretroviral treatment (ART)-naïve individuals between 2010 and 2013 were analysed for the presence of transmitted drug resistance mutations (TDRMs), defined as any mutations from a modified 2009 World Health Organization surveillance list, or a modified 2013 International Antiviral Society-USA list for integrase tests. Logistic regression was used to examine associations between demographics and the prevalence of TDRMs.<h4>Results</h4>TDRMs were observed in 1223 (7.5%) of 16 425 individuals; prevalence declined from 8.1% in 2010 to 6.6% in 2013 (P = 0.02). The prevalence of TDRMs was higher among men who have sex with men (MSM) compared with heterosexual men and women (8.7% versus 6.4%, respectively) with a trend for decreasing TDRMs among MSM (P = 0.008) driven by a reduction in nucleoside reverse transcriptase inhibitor (NRTI)-related mutations. The most frequently detected TDRMs were K103N (2.2%), T215 revertants (1.6%), M41L (0.9%) and L90M (0.7%). Predicted phenotypic resistance to first-line ART was highest to the nonnucleoside reverse transcriptase inhibitors (NNRTIs) rilpivirine and efavirenz (6.2% and 3.4%, respectively) but minimal to NRTIs, including tenofovir, and protease inhibitors (PIs). No major integrase TDRMs were detected among 101 individuals tested while ART-naïve.<h4>Conclusions</h4>We observed a decrease in TDRMs in recent years. However, this was confined to the MSM population and rates remained stable in those with heterosexually acquired HIV infection. Resistance to currently recommended first-line ART, including integrase inhibitors, remained reassuringly low.

Item Type: Article
Uncontrolled Keywords: drug resistance, HIV-1, mutations, transmitted, transmitted drug resistance, transmitted drug resistance mutations
Depositing User: Symplectic Admin
Date Deposited: 27 Jan 2017 09:46
Last Modified: 19 Jan 2023 07:20
DOI: 10.1111/hiv.12414
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3005409
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