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

Tostevin, A and White, E and Dunn, D and Croxford, S and Delpech, V and Williams, I and Asboe, D and Pozniak, A and Churchill, D and Geretti, A M and Pillay, D and Sabin, C and Leigh-Brown, A and Smit, E (2016) Recent trends and patterns in HIV-1 transmitted drug resistance in the United Kingdom. HIV medicine. ISSN 1468-1293. This article is available to all HEFT staff and students via ASK HEFT Discovery tool www.heftlibrary.nhs.uk using their HEFT Athens Login.

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Official URL: http://onlinelibrary.wiley.com/doi/10.1111/hiv.124...

Abstract

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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
Additional Information: This article is available to all HEFT staff and students via ASK HEFT Discovery tool www.heftlibrary.nhs.uk using their HEFT Athens Login.
Subjects: WC Communicabable diseases
Divisions: Clinical Support > Pathology
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Depositing User: Mrs Yolande Brookes
Date Deposited: 02 Feb 2017 10:30
Last Modified: 02 Feb 2017 10:30
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1141

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