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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Prevalence of transmitted HIV-1 drug resistance and the role of resistance algorithms: Data from seroconverters in the CASCADE collaboration from 1987 to 2003
Journal of Acquired Immune Deficiency Syndromes, Volume 40, No. 5, Year 2005
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Description
Objectives: To examine factors influencing the rate of transmitted drug resistance (TDR) among seroconverters, with particular emphasis on 3 widely used genotypic drug resistance algorithms. Methods: The study used data from CASCADE (Concerted Action on Seroconversion to AIDS and Death in Europe), a collaboration of seroconverter cohorts in Europe and Canada. Genotypic resistance data were derived within 18 months of the last seronegative test or date of laboratory evidence of acute infection and before the initiation of antiretroviral therapy. The Stanford algorithm was used to analyze each individual's nucleotide sequence. A multivariate logistic model was used to assess independent relationships between the presence of TDR and exposure category, sex, age at seroconversion, and year of seroconversion. The paper also describes 3 alternative definitions of resistance: the Stanford algorithm, the key resistance mutations defined by the International AIDS Society, and the Agence Nationale de Recherches sur le Sida (ANRS) algorithm. Results: Forty-five of 438 patients (10.3%) seroconverting between 1987 and 2003 were infected with a drug-resistant HIV-1 variant. Forty patients (9.1%) showed resistance mutations to only 1 class of antiretroviral drugs, 2 (0.5%) to 2 classes, and 3 (0.7%) to 3 classes of antiretroviral therapy. It was suggested that individuals seroconverting later in calendar time were more likely to have TDR (relative risk 3.89 and 95% CI: 0.84 to 18.02, and relative risk 4.69 and 95% CI: 1.03 to 21.31, for 1996-1999 and 2000-2003, respectively, compared with pre-1996; P trend = 0.08). This trend was apparent regardless of the definition of TDR used. The total estimated proportion of individuals with TDR varied between 10.3% and 15.5% according to which definition was used. Conclusions: Evidence was found for the rise of TDR over time. A specific definition of what constitutes TDR rather than a simple list of mutations is needed. Copyright © 2005 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Masquelier, Bernard
France, Talence
Centre Hospitalier Universitaire de Bordeaux
Morris, Lynn G.
United Kingdom, London
Ucl Medical School
Gifford, Robert J.M.
United Kingdom, London
Ucl Medical School
Balestre, Eric
France, Paris
Inserm
Jörgensen, Louise Bruun
Denmark, Copenhagen
Statens Serum Institut
Pedersen, Court K.
Denmark, Odense
Odense Universitetshospital
van der Hoek, Lia M.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Prins, Maria
Netherlands, Amsterdam
Municipal Health Service of Amsterdam
Balotta, Claudia
Italy, Milan
Università Degli Studi Di Milano
Kücherer, Claudia
Germany, Berlin
Robert Koch Institute
Poggensee, Gabriele
Germany, Berlin
Robert Koch Institute
de-Mendoza, Carmen
Spain, Madrid
Hospital Universitario la Paz
Gill, M. John
Unknown Affiliation
Fleury, Hervè J.A.
France, Talence
Centre Hospitalier Universitaire de Bordeaux
Porter, Kholoud
United Kingdom, London
Mrc Clinical Trials Unit
Statistics
Citations: 92
Authors: 15
Affiliations: 12
Identifiers
Doi:
10.1097/01.qai.0000186361.42834.61
ISSN:
15254135
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study