Infrequent transmission of HIV-1 drug-resistant variants

Article Article scientifique Article Infrequent transmission of HIV-1 drug-resistant variants eng 2004 author Yerly Ferrillo Sabine 23752 author Jost Stéphanie author Telenti Amalio author Flepp Markus author Kaiser Laurent 28229 author Chave J. P. author Vernazza Pietro author Battegay Manuel author Furrer Hansjakob author Chanzy Bruno author Burgisser Philippe author Rickenbach Martin author Gebhardt Martin author Bernard Marie-Charlotte 133788 author Perneger Thomas 28462 author Hirschel Bernard 22746 author Perrin Luc 25543 375-384 15259900 1359-6535 http://www.intmedpress.com/serveFile.cfm?sUID=03d1b475-d606-4bd0-85e1-aae2d528b576 Transmission of drug-resistant variants is influenced by several factors, including the prevalence of drug resistance in the population of HIV-1-infected patients, HIV-1 RNA levels and transmission by recently infected patients. In order to evaluate the impact of these factors on the transmission of drug-resistant variants, we have defined the population of potential transmitters and compared their resistance profiles to those of newly infected patients. Sequencing of pol gene was performed in 220 recently infected patients and in 373 chronically infected patients with HIV-1 RNA >1000 copies/ml. Minimal and maximal drug-resistance profiles of potential transmitters were estimated by weighting resistance profiles of chronically infected patients with estimates of the Swiss HIV-1-infected population, the prevalence of exposure to antiviral drugs and the proportion of infections attributed to primary HIV infections. The drug-resistance prevalence in recently infected patients was 10.5% (one class drug resistance: 9.1%; two classes: 1.4%; three classes: 0%). Phylogenetic analysis revealed significant clustering for 30% of recent infections. The drug-resistance prevalence in chronically infected patients was 72.4% (one class: 29%; two classes: 27.6%; three classes: 15.8%). After adjustment, the risk of transmission relative to wild-type was reduced both for one class drug resistance (minimal and maximal estimates: odds ratio: 0.39, P<0.001; and odds ratio: 0.55, P=0.011, respectively), and for two to three class drug resistance (odds ratios: 0.05 and 0.07, respectively, P<0.001). Neither sexual behaviour nor HIV-1 RNA levels explained the low transmission of drug-resistant variants. These data suggest that drug-resistant variants and in particular multidrug-resistant variants have a substantially reduced transmission capacity. Adolescent Adult Aged Anti-Retroviral Agents/pharmacology/ therapeutic use Chronic Disease Disease Transmission, Infectious Drug Resistance, Viral/ genetics Female Genes, pol Genetic Variation Genotype HIV Infections/ drug therapy/epidemiology/ transmission HIV-1/ drug effects/genetics/isolation & purification Humans Male Middle Aged Odds Ratio Phylogeny Prevalence RNA, Viral/analysis Risk Factors Switzerland/epidemiology Dewey 616 56 Département de médecine 221 false 88 Epidémiologie clinique 115 Antiviral therapy 9 3 2ea1fd01-952b-409c-97c3-c9bd258a5c03 Article Restricted file1.pdf 183353 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de médecine

Title	Published in	Year	Views	Downloads

Infrequent transmission of HIV-1 drug-resistant variants	Antiviral therapy	2004	616	0
A patient with HIV-1 superinfection	The New England journal of medicine	2002	573	0

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Bernard, Marie-Charlotte