Author:
|
Ambrosioni, Juan; Sued, Omar; Nicolas, David; Parera, Marta; López-Diéguez, María; Romero, Anabel; Agüero Santangelo, Fernando; Marcos Maeso, Ma. Angeles; Manzardo, Christian; Zamora, Laura; Gómez-Carrillo, Manuel; Gatell, José M.; Pumarola Suñé, Tomás; Miró Meda, José M.
|
Abstract:
|
OBJECTIVES: To evaluate the prevalence of transmitted drug
resistance (TDR) and non-B subtypes in patients with
acute/recent HIV-1 infection in Barcelona during the period
1997-2012. METHODS: Patients from the "Hospital Clinic Primary
HIV-1 Infection Cohort" with a genotyping test performed within
180 days of infection were included. The 2009 WHO List of
Mutations for Surveillance of Transmitted HIV-1 Drug Resistance
was used for estimating the prevalence of TDR and phylogenetic
analysis for subtype determination. RESULTS: 189 patients with
acute/recent HIV-1 infection were analyzed in 4 time periods
(1997-2000, n=28; 2001-4, n=42; 2005-8, n=55 and 2009-12, n=64).
The proportion of patients with acute/recent HIV-1 infection
with respect to the total of newly HIV-diagnosed patients in our
center increased over the time and was 2.18%, 3.82%, 4.15% and
4.55% for the 4 periods, respectively (p=0.005). The global
prevalence of TDR was 9%, or 17.9%, 9.5%, 3.6% and 9.4% by study
period (p=0.2). The increase in the last period was driven by
protease-inhibitor and
nucleoside-reverse-transcriptase-inhibitor resistance mutations
while non-nucleoside-reverse-transcriptase inhibitor TDR and TDR
of more than one family decreased. The overall prevalence of
non-B subtypes was 11.1%, or 0%, 4.8%, 9.1% and 20.3 by study
period (p=0.01). B/F recombinants, B/G recombinants and subtype
F emerged in the last period. We also noticed an increase in the
number of immigrant patients (p=0.052). The proportion of
men-who-have-sex-with-men (MSM) among patients with acute/recent
HIV-1 infection increased over the time (p=0.04). CONCLUSIONS:
The overall prevalence of TDR in patients with acute/recent
HIV-1 infection in Barcelona was 9%, and it has stayed
relatively stable in recent years. Non-B subtypes and immigrants
proportions progressively increased. |