Recent trends and patterns in HIV‐1 transmitted drug resistance in the United Kingdom. Issue 3 (1st August 2016)

• Record Type: Journal Article
• Authors: Tostevin, A; White, E; Dunn, D; Croxford, S; Delpech, V; Williams, I; Asboe, D; Pozniak, A; Churchill, D; Geretti, AM; Pillay, D; Sabin, C; Leigh‐Brown, A; Smit, E
• Other Names: Aitken Celia investigator.; Cane Patricia investigator.; Chadwick David investigator.; Clark Duncan investigator.; Collins Simon investigator.; Douthwaite Samuel investigator.; Fearnhill Esther investigator.; Porter Kholoud investigator.; Fraser Christophe investigator.; Hale Antony investigator.; Hué Stéphane investigator.; Kaye Steve investigator.; Kellam Paul investigator.; Lazarus Linda investigator.; Mbisa Tamyo investigator.; Mackie Nicola investigator.; Moses Samuel investigator.; Orkin Chloe investigator.; Nastouli Eleni investigator.; Phillips Andrew investigator.; Templeton Kate investigator.; Tilston Peter investigator.; Zhang Hongyi investigator.; Fairbrother Keith investigator.; Greatorex Jane investigator.; O'Shea Siobhan investigator.; Mullen Jane investigator.; Cox Alison investigator.; Tandy Richard investigator.; Fawcett Tracy investigator.; Hopkins Mark investigator.; Ashton Lynne investigator.; Booth Clare investigator.; Garcia‐Diaz Ana investigator.; Shepherd Jill investigator.; Schmid Matthias L. investigator.; Payne Brendan investigator.; Pereira Spiro investigator.; Hubb Jonathan investigator.; Kirk Stuart investigator.; Gunson Rory investigator.; Bradley‐Stewart Amanda investigator.;
• Is Part Of: HIV medicine. Volume 18:Issue 3(2017:Mar.)
• Page Start: 204
• Page End: 213
• Publication Date: 2016-08-01
• Subjects: drug resistance -- HIV‐1 -- mutations -- transmitted -- transmitted drug resistance -- transmitted drug resistance mutations; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12414
• Languages: English
• ISSNs: 1464-2662

Abstract

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.