Low prevalence of transmitted drug resistance in patients newly diagnosed with HIV-1 infection in Sweden 2003-2010.
Low prevalence of transmitted drug resistance in patients newly diagnosed with HIV-1 infection in Sweden 2003-2010.
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DOI：
10.1371/journal.pone.0033484
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Albert J
中科院分区：
文献类型：
--
作者：
Karlsson A;Björkman P;Bratt G;Ekvall H;Gisslén M;Sönnerborg A;Mild M;Albert J
传播耐药性（TDR）是一个临床和流行病学问题，因为它可能导致抗逆转录病毒治疗失败。 TDR 的患病率因地区而异，过去十年在瑞典的患病率尚未有报道。使用 WHO 2009 年 TDR 监测突变列表对 2003 年至 2010 年间新诊断出的 1,463 名 HIV-1 感染患者（占瑞典同期诊断出的所有患者的 44%）的血浆样本进行了分析。使用最大似然系统发育分析来确定遗传亚型并研究序列的相关性。 82 名患者表现出 TDR 证据，患病率为 5.6%（95% CI：4.5%–6.9%），在瑞典或国外感染的患者之间没有任何显着的时间趋势或差异。多变量逻辑回归显示，TDR 与男男性行为 (MSM) 和 B 亚型感染呈正相关，与 CD4 细胞计数呈负相关。在 TDR 患者中，54 名 (68%) 患有单一耐药突变，而 5 名患者患有多重耐药 HIV-1。系统发育分析确定了 9 个显着支持的簇，涉及 29 名 TDR 患者，其中包括在瑞典获得的 42 名 TDR 患者中的 23 名 (55%)。其中一个簇包含 18 种带有 M41L 抗性突变的病毒，这些病毒在斯德哥尔摩的 MSM 中传播了至少 16 年（1994 年至 2010 年）。另一个包含五种多重耐药病毒的病毒群也涉及来自斯德哥尔摩的 MSM。 2003-2010 年瑞典 TDR 患病率低于许多其他欧洲国家。 TDR 集中在 MSM 中，观察到 TDR 菌株聚集，这凸显了需要持续和改进针对性干预措施。
Transmitted drug resistance (TDR) is a clinical and epidemiological problem because it may contribute to failure of antiretroviral treatment. The prevalence of TDR varies geographically, and its prevalence in Sweden during the last decade has not been reported. Plasma samples from 1,463 patients newly diagnosed with HIV-1 infection between 2003 and 2010, representing 44% of all patients diagnosed in Sweden during this period, were analyzed using the WHO 2009 list of mutations for surveillance of TDR. Maximum likelihood phylogenetic analyses were used to determine genetic subtype and to investigate the relatedness of the sequences. Eighty-two patients showed evidence of TDR, representing a prevalence of 5.6% (95% CI: 4.5%–6.9%) without any significant time trends or differences between patients infected in Sweden or abroad. Multivariable logistic regression showed that TDR was positively associated with men who have sex with men (MSM) and subtype B infection and negatively associated with CD4 cell counts. Among patients with TDR, 54 (68%) had single resistance mutations, whereas five patients had multi-drug resistant HIV-1. Phylogenetic analyses identified nine significantly supported clusters involving 29 of the patients with TDR, including 23 of 42 (55%) of the patients with TDR acquired in Sweden. One cluster contained 18 viruses with a M41L resistance mutation, which had spread among MSM in Stockholm over a period of at least 16 years (1994–2010). Another cluster, which contained the five multidrug resistant viruses, also involved MSM from Stockholm. The prevalence of TDR in Sweden 2003–2010 was lower than in many other European countries. TDR was concentrated among MSM, where clustering of TDR strains was observed, which highlights the need for continued and improved measures for targeted interventions.
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影响因子：
3
作者：
Murillo, W.;de Rivera, I. L.;Albert, J.
通讯作者：
Albert, J.
影响因子：
3.7
作者：
Bennett DE;Camacho RJ;Otelea D;Kuritzkes DR;Fleury H;Kiuchi M;Heneine W;Kantor R;Jordan MR;Schapiro JM;Vandamme AM;Sandstrom P;Boucher CA;van de Vijver D;Rhee SY;Liu TF;Pillay D;Shafer RW
通讯作者：
Shafer RW
影响因子：
3.8
作者：
Burns, Sheila;Cameron, Sheila;Pillay, Deenan
通讯作者：
Pillay, Deenan
影响因子：
5.2
作者：
Descamps, Diane;Chaix, Marie-Laure;Costagliola, Dominique
通讯作者：
Costagliola, Dominique
影响因子：
1.5
作者：
Maljkovic, I;Wilbe, K;Leitner, T
通讯作者：
Leitner, T