Increasing prevalence of HIV-1 transmitted drug resistance in Portugal

Detalhes bibliográficos
Autor(a) principal: Pingarilho, Marta
Data de Publicação: 2020
Outros Autores: Pimentel, Victor, Diogo, Isabel, Fernandes, Sandra, Miranda, Mafalda, Pineda-Peña, AC, Libin, Pieter, Theys, Kristof, Martins, MR, Vandamme, AM, Camacho, Ricardo J., Gomes, Perpétua, Abecasis, AB
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/116490
Resumo: Introduction: Treatment for All recommendations have allowed access to antiretroviral (ARV) treatment for an increasing number of patients. This minimizes the transmission of infection but can potentiate the risk of transmitted (TDR) and acquired drug resistance (ADR). Objective: To study the trends of TDR and ADR in patients followed up in Portuguese hospitals between 2001 and 2017. Methods: In total, 11,911 patients of the Portuguese REGA database were included. TDR was defined as the presence of one or more surveillance drug resistance mutation according to the WHO surveillance list. Genotypic resistance to ARV was evaluated with Stanford HIVdb v7.0. Patterns of TDR, ADR and the prevalence of mutations over time were analyzed using logistic regression. Results and Discussion: The prevalence of TDR increased from 7.9% in 2003 to 13.1% in 2017 (p < 0.001). This was due to a significant increase in both resistance to nucleotide reverse transcriptase inhibitors (NRTIs) and non-nucleotide reverse transcriptase inhibitors (NNRTIs), from 5.6% to 6.7% (p = 0.002) and 2.9% to 8.9% (p < 0.001), respectively. TDR was associated with infection with subtype B, and with lower viral load levels (p < 0.05). The prevalence of ADR declined from 86.6% in 2001 to 51.0% in 2017 (p < 0.001), caused by decreasing drug resistance to all antiretroviral (ARV) classes (p < 0.001). Conclusions: While ADR has been decreasing since 2001, TDR has been increasing, reaching a value of 13.1% by the end of 2017. It is urgently necessary to develop public health programs to monitor the levels and patterns of TDR in newly diagnosed patients.
id RCAP_f7d73d777faf678f7cfb9df33bee7bf7
oai_identifier_str oai:run.unl.pt:10362/116490
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling Increasing prevalence of HIV-1 transmitted drug resistance in Portugalimplications for first line treatment recommendationsHIV-1Transmitted drug resistanceAcquired drug resistancePortugalVirologyEpidemiologyInfectious DiseasesSDG 3 - Good Health and Well-beingIntroduction: Treatment for All recommendations have allowed access to antiretroviral (ARV) treatment for an increasing number of patients. This minimizes the transmission of infection but can potentiate the risk of transmitted (TDR) and acquired drug resistance (ADR). Objective: To study the trends of TDR and ADR in patients followed up in Portuguese hospitals between 2001 and 2017. Methods: In total, 11,911 patients of the Portuguese REGA database were included. TDR was defined as the presence of one or more surveillance drug resistance mutation according to the WHO surveillance list. Genotypic resistance to ARV was evaluated with Stanford HIVdb v7.0. Patterns of TDR, ADR and the prevalence of mutations over time were analyzed using logistic regression. Results and Discussion: The prevalence of TDR increased from 7.9% in 2003 to 13.1% in 2017 (p < 0.001). This was due to a significant increase in both resistance to nucleotide reverse transcriptase inhibitors (NRTIs) and non-nucleotide reverse transcriptase inhibitors (NNRTIs), from 5.6% to 6.7% (p = 0.002) and 2.9% to 8.9% (p < 0.001), respectively. TDR was associated with infection with subtype B, and with lower viral load levels (p < 0.05). The prevalence of ADR declined from 86.6% in 2001 to 51.0% in 2017 (p < 0.001), caused by decreasing drug resistance to all antiretroviral (ARV) classes (p < 0.001). Conclusions: While ADR has been decreasing since 2001, TDR has been increasing, reaching a value of 13.1% by the end of 2017. It is urgently necessary to develop public health programs to monitor the levels and patterns of TDR in newly diagnosed patients.Global Health and Tropical Medicine (GHTM)Instituto de Higiene e Medicina Tropical (IHMT)TB, HIV and opportunistic diseases and pathogens (THOP)Population health, policies and services (PPS)RUNPingarilho, MartaPimentel, VictorDiogo, IsabelFernandes, SandraMiranda, MafaldaPineda-Peña, ACLibin, PieterTheys, KristofMartins, MRVandamme, AMCamacho, Ricardo J.Gomes, PerpétuaAbecasis, AB2021-04-30T22:42:57Z2020-10-302020-10-30T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article16application/pdfhttp://hdl.handle.net/10362/116490eng1999-4915PURE: 26202487https://doi.org/10.3390/v12111238info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:59:05Zoai:run.unl.pt:10362/116490Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:43:05.318991Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Increasing prevalence of HIV-1 transmitted drug resistance in Portugal
implications for first line treatment recommendations
title Increasing prevalence of HIV-1 transmitted drug resistance in Portugal
spellingShingle Increasing prevalence of HIV-1 transmitted drug resistance in Portugal
Pingarilho, Marta
HIV-1
Transmitted drug resistance
Acquired drug resistance
Portugal
Virology
Epidemiology
Infectious Diseases
SDG 3 - Good Health and Well-being
title_short Increasing prevalence of HIV-1 transmitted drug resistance in Portugal
title_full Increasing prevalence of HIV-1 transmitted drug resistance in Portugal
title_fullStr Increasing prevalence of HIV-1 transmitted drug resistance in Portugal
title_full_unstemmed Increasing prevalence of HIV-1 transmitted drug resistance in Portugal
title_sort Increasing prevalence of HIV-1 transmitted drug resistance in Portugal
author Pingarilho, Marta
author_facet Pingarilho, Marta
Pimentel, Victor
Diogo, Isabel
Fernandes, Sandra
Miranda, Mafalda
Pineda-Peña, AC
Libin, Pieter
Theys, Kristof
Martins, MR
Vandamme, AM
Camacho, Ricardo J.
Gomes, Perpétua
Abecasis, AB
author_role author
author2 Pimentel, Victor
Diogo, Isabel
Fernandes, Sandra
Miranda, Mafalda
Pineda-Peña, AC
Libin, Pieter
Theys, Kristof
Martins, MR
Vandamme, AM
Camacho, Ricardo J.
Gomes, Perpétua
Abecasis, AB
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Global Health and Tropical Medicine (GHTM)
Instituto de Higiene e Medicina Tropical (IHMT)
TB, HIV and opportunistic diseases and pathogens (THOP)
Population health, policies and services (PPS)
RUN
dc.contributor.author.fl_str_mv Pingarilho, Marta
Pimentel, Victor
Diogo, Isabel
Fernandes, Sandra
Miranda, Mafalda
Pineda-Peña, AC
Libin, Pieter
Theys, Kristof
Martins, MR
Vandamme, AM
Camacho, Ricardo J.
Gomes, Perpétua
Abecasis, AB
dc.subject.por.fl_str_mv HIV-1
Transmitted drug resistance
Acquired drug resistance
Portugal
Virology
Epidemiology
Infectious Diseases
SDG 3 - Good Health and Well-being
topic HIV-1
Transmitted drug resistance
Acquired drug resistance
Portugal
Virology
Epidemiology
Infectious Diseases
SDG 3 - Good Health and Well-being
description Introduction: Treatment for All recommendations have allowed access to antiretroviral (ARV) treatment for an increasing number of patients. This minimizes the transmission of infection but can potentiate the risk of transmitted (TDR) and acquired drug resistance (ADR). Objective: To study the trends of TDR and ADR in patients followed up in Portuguese hospitals between 2001 and 2017. Methods: In total, 11,911 patients of the Portuguese REGA database were included. TDR was defined as the presence of one or more surveillance drug resistance mutation according to the WHO surveillance list. Genotypic resistance to ARV was evaluated with Stanford HIVdb v7.0. Patterns of TDR, ADR and the prevalence of mutations over time were analyzed using logistic regression. Results and Discussion: The prevalence of TDR increased from 7.9% in 2003 to 13.1% in 2017 (p < 0.001). This was due to a significant increase in both resistance to nucleotide reverse transcriptase inhibitors (NRTIs) and non-nucleotide reverse transcriptase inhibitors (NNRTIs), from 5.6% to 6.7% (p = 0.002) and 2.9% to 8.9% (p < 0.001), respectively. TDR was associated with infection with subtype B, and with lower viral load levels (p < 0.05). The prevalence of ADR declined from 86.6% in 2001 to 51.0% in 2017 (p < 0.001), caused by decreasing drug resistance to all antiretroviral (ARV) classes (p < 0.001). Conclusions: While ADR has been decreasing since 2001, TDR has been increasing, reaching a value of 13.1% by the end of 2017. It is urgently necessary to develop public health programs to monitor the levels and patterns of TDR in newly diagnosed patients.
publishDate 2020
dc.date.none.fl_str_mv 2020-10-30
2020-10-30T00:00:00Z
2021-04-30T22:42:57Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/116490
url http://hdl.handle.net/10362/116490
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1999-4915
PURE: 26202487
https://doi.org/10.3390/v12111238
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 16
application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1799138041281904640