Increasing prevalence of HIV-1 transmitted drug resistance in Portugal
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , , , , |
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. |
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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 |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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