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Increase in transmitted resistance to non-nucleoside reverse transcriptase inhibitors among newly diagnosed HIV-1 infections in Europe

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Abstract
Background: One out of ten newly diagnosed patients in Europe was infected with a virus carrying a drug resistant mutation. We analysed the patterns over time for transmitted drug resistance mutations (wTDRM) using data from the European Spread program. Methods: Clinical, epidemiological and virological data from 4317 patients newly diagnosed with HIV-1 infection between 2002 and 2007 were analysed. Patients were enrolled using a pre-defined sampling strategy. Results: The overall prevalence of TDRM in this period was 8.9% (95% CI: 8.1-9.8). Interestingly, significant changes over time in TDRM caused by the different drug classes were found. Whereas nucleoside resistance mutations remained constant at 5%, a significant decline in protease inhibitors resistance mutations was observed, from 3.9% in 2002 to 1.6% in 2007 (p = 0.001). In contrast, resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) doubled from 2.0% in 2002 to 4.1% in 2007 (p = 0.004) with 58% of viral strains carrying a K103N mutation. Phylogenetic analysis showed that these temporal changes could not be explained by large clusters of TDRM. Conclusion: During the years 2002 to 2007 transmitted resistance to NNRTI has doubled to 4% in Europe. The frequent use of NNRTI in first-line regimens and the clinical impact of NNRTI mutations warrants continued monitoring.
Keywords
THERAPY, Europe, NAIVE PATIENTS, ANTIRETROVIRAL DRUG-RESISTANCE, MOLECULAR EPIDEMIOLOGY, SOCIETY-USA PANEL, PREVALENCE, UNITED-KINGDOM, Transmission, UPDATED RECOMMENDATIONS, MUTATIONS, Resistance, TRANSMISSION, HIV-1

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MLA
Frentz, Dineke et al. “Increase in Transmitted Resistance to Non-nucleoside Reverse Transcriptase Inhibitors Among Newly Diagnosed HIV-1 Infections in Europe.” BMC INFECTIOUS DISEASES 14 (2014): n. pag. Print.
APA
Frentz, D., Van de Vijver, D. A., Abecasis, A. B., Albert, J., Hamouda, O., Jørgensen, L. B., Kücherer, C., et al. (2014). Increase in transmitted resistance to non-nucleoside reverse transcriptase inhibitors among newly diagnosed HIV-1 infections in Europe. BMC INFECTIOUS DISEASES, 14.
Chicago author-date
Frentz, Dineke, David AMC Van de Vijver, Ana B Abecasis, Jan Albert, Osamah Hamouda, Louise B Jørgensen, Claudia Kücherer, et al. 2014. “Increase in Transmitted Resistance to Non-nucleoside Reverse Transcriptase Inhibitors Among Newly Diagnosed HIV-1 Infections in Europe.” Bmc Infectious Diseases 14.
Chicago author-date (all authors)
Frentz, Dineke, David AMC Van de Vijver, Ana B Abecasis, Jan Albert, Osamah Hamouda, Louise B Jørgensen, Claudia Kücherer, Daniel Struck, Jean-Claude Schmit, Jurgen Vercauteren, Birgitta Åsjö, Claudia Balotta, Daniel Beshkov, Ricardo J Camacho, Bonaventura Clotet, Suzie Coughlan, Algirdas Griskevicius, Zehava Grossman, Andrezj Horban, Tatjana Kolupajeva, Klaus Korn, Leondios G Kostrikis, Kirsi Liitsola, Marek Linka, Claus Nielsen, Dan Otelea, Dimitrios Paraskevis, Roger Paredes, Mario Poljak, Elisabeth Puchhammer-Stöckl, Anders Sönnerborg, Danica Stanekova, Maja Stanojevic, Eric Van Wijngaerden, Annemarie MJ Wensing, Charles AB Boucher, on behalf of the SPREAD Programme, and Linos Vandekerckhove. 2014. “Increase in Transmitted Resistance to Non-nucleoside Reverse Transcriptase Inhibitors Among Newly Diagnosed HIV-1 Infections in Europe.” Bmc Infectious Diseases 14.
Vancouver
1.
Frentz D, Van de Vijver DA, Abecasis AB, Albert J, Hamouda O, Jørgensen LB, et al. Increase in transmitted resistance to non-nucleoside reverse transcriptase inhibitors among newly diagnosed HIV-1 infections in Europe. BMC INFECTIOUS DISEASES. 2014;14.
IEEE
[1]
D. Frentz et al., “Increase in transmitted resistance to non-nucleoside reverse transcriptase inhibitors among newly diagnosed HIV-1 infections in Europe,” BMC INFECTIOUS DISEASES, vol. 14, 2014.
@article{5913344,
  abstract     = {Background: One out of ten newly diagnosed patients in Europe was infected with a virus carrying a drug resistant mutation. We analysed the patterns over time for transmitted drug resistance mutations (wTDRM) using data from the European Spread program. 
Methods: Clinical, epidemiological and virological data from 4317 patients newly diagnosed with HIV-1 infection between 2002 and 2007 were analysed. Patients were enrolled using a pre-defined sampling strategy. 
Results: The overall prevalence of TDRM in this period was 8.9% (95% CI: 8.1-9.8). Interestingly, significant changes over time in TDRM caused by the different drug classes were found. Whereas nucleoside resistance mutations remained constant at 5%, a significant decline in protease inhibitors resistance mutations was observed, from 3.9% in 2002 to 1.6% in 2007 (p = 0.001). In contrast, resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) doubled from 2.0% in 2002 to 4.1% in 2007 (p = 0.004) with 58% of viral strains carrying a K103N mutation. Phylogenetic analysis showed that these temporal changes could not be explained by large clusters of TDRM. 
Conclusion: During the years 2002 to 2007 transmitted resistance to NNRTI has doubled to 4% in Europe. The frequent use of NNRTI in first-line regimens and the clinical impact of NNRTI mutations warrants continued monitoring.},
  articleno    = {407},
  author       = {Frentz, Dineke and Van de Vijver, David AMC and Abecasis, Ana B and Albert, Jan and Hamouda, Osamah and Jørgensen, Louise B and Kücherer, Claudia and Struck, Daniel and Schmit, Jean-Claude and Vercauteren, Jurgen and Åsjö, Birgitta and Balotta, Claudia and Beshkov, Daniel and Camacho, Ricardo J and Clotet, Bonaventura and Coughlan, Suzie and Griskevicius, Algirdas and Grossman, Zehava and Horban, Andrezj and Kolupajeva, Tatjana and Korn, Klaus and Kostrikis, Leondios G and Liitsola, Kirsi and Linka, Marek and Nielsen, Claus and Otelea, Dan and Paraskevis, Dimitrios and Paredes, Roger and Poljak, Mario and Puchhammer-Stöckl, Elisabeth and Sönnerborg, Anders and Stanekova, Danica and Stanojevic, Maja and Van Wijngaerden, Eric and Wensing, Annemarie MJ and Boucher, Charles AB and SPREAD Programme, on behalf of the and Vandekerckhove, Linos},
  issn         = {1471-2334},
  journal      = {BMC INFECTIOUS DISEASES},
  keywords     = {THERAPY,Europe,NAIVE PATIENTS,ANTIRETROVIRAL DRUG-RESISTANCE,MOLECULAR EPIDEMIOLOGY,SOCIETY-USA PANEL,PREVALENCE,UNITED-KINGDOM,Transmission,UPDATED RECOMMENDATIONS,MUTATIONS,Resistance,TRANSMISSION,HIV-1},
  language     = {eng},
  pages        = {12},
  title        = {Increase in transmitted resistance to non-nucleoside reverse transcriptase inhibitors among newly diagnosed HIV-1 infections in Europe},
  url          = {http://dx.doi.org/10.1186/1471-2334-14-407},
  volume       = {14},
  year         = {2014},
}

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