Infrequent Transmission of HIV-1 Drug-Resistant Variants
Infrequent Transmission of HIV-1 Drug-Resistant Variants
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HIV-1 耐药变异体的罕见传播
DOI：
10.1177/135965350400900312
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发表时间：
2003
影响因子：
1.2
通讯作者：
L. Perrin
中科院分区：
文献类型：
--
作者：
S. Yerly;S. Jost;A. Telenti;M. Flepp;L. Kaiser;J. Chave;P. Vernazza;M. Battegay;H. Furrer;B. Chanzy;P. Burgisser;M. Rickenbach;M. Gebhardt;Marie‐Charlotte Bernard;T. Perneger;B. Hirschel;L. Perrin
耐药变异体的传播受若干因素的影响，包括艾滋病毒1感染患者群体中耐药的普遍程度、艾滋病毒1 RNA水平和最近感染患者的传播。为了评估这些因素对耐药变异传播的影响，我们定义了潜在传播者的人群，并将其耐药性与新感染患者的耐药性进行了比较。对220例HIV-1 RNA > 1000 copies/ml的近期感染者和373例HIV-1 RNA >1000 copies/ml的慢性感染者进行pol基因测序。潜在传播者的最小和最大耐药概况通过对慢性感染患者的耐药概况进行加权来估计，并估计瑞士HIV-1感染人群、抗病毒药物暴露的流行率和归因于原发性HIV感染的感染比例。近期感染者耐药率为10.5%（1级耐药9.1%; 2级耐药1.4%; 3级耐药0%）。系统发育分析显示，30%的近期感染有显著的聚集性。慢性感染者耐药率为72.4%，其中一级耐药率为29%，二级耐药率为27.6%，三级耐药率为15.8%。调整后，与野生型相比，一级耐药（最小和最大估计值：比值比：0.39，P<0.001;比值比：0.55，P=0.011）和二级至三级耐药（比值比：0.05和0.07，P<0.001）的传播风险降低。性行为和HIV-1 RNA水平都不能解释耐药变异的低传播。这些数据表明，耐药变异体，特别是多药耐药变异体的传播能力大大降低。
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.
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影响因子：
120.7
作者：
Grant, RM;Hecht, FM;Kahn, JO
通讯作者：
Kahn, JO
影响因子：
158.5
作者：
Little, SJ;Holte, S;Richman, DD
通讯作者：
Richman, DD
影响因子：
158.5
作者：
Quinn, TC;Wawer, MJ;Gray, RH
通讯作者：
Gray, RH
影响因子：
120.7
作者：
Boden, D;Hurley, A;Markowitz, M
通讯作者：
Markowitz, M
影响因子：
6.4
作者：
Brown, AJL;Frost, SDW;Little, SJ
通讯作者：
Little, SJ