Evidence of Self-Sustaining Drug Resistant HIV-1 Lineages Among Untreated Patients in the United Kingdom

TitleEvidence of Self-Sustaining Drug Resistant HIV-1 Lineages Among Untreated Patients in the United Kingdom
Publication TypeJournal Article
Year of Publication2015
AuthorsMbisa JL, Fearnhill E, Dunn D, Pillay D, Asboe D, Cane P A
JournalClin Infect Dis
Volume61
Pagination829-36
Date Published2015-09
ISBN Number1058-4838
Accession Number25991470
KeywordsDrug Resistance, Viral/*genetics, Female, Great Britain/epidemiology, HIV Infections/*epidemiology/*virology, HIV-1-transmitted drug resistance, HIV-1/*classification/*genetics, Humans, Male, Models, Statistical, Phylogeny, subtype B, treatment-naive patients
Abstract

BACKGROUND: About 10% of new diagnoses of subtype B human immunodeficiency virus type 1 (HIV-1) in the United Kingdom are with viruses showing transmitted drug resistance (TDR). However, there is discordance between the mutation patterns observed in HIV-infected patients failing therapy and those seen in TDR. METHODS: We extracted all subtype B HIV-1 pol gene sequences from treatment-naive patients within the United Kingdom HIV Drug Resistance Database sampled between 1997 and 2011 and carrying the most common protease inhibitors, nonnucleoside and nucleotide reverse transcriptase inhibitors TDR mutations, namely, L90M, K103N, and T215Y/F/rev, respectively (n = 1140). Transmission clusters (n >/= 2 sequences) were identified by maximum-likelihood phylogeny using a genetic distance cutoff of

/= 8 sequences) was estimated to be between 2000 (1999-2002; 95% highest posterior density [HPD]) and 2006 (2005-2007; 95% HPD). The oldest cluster had persisted for nearly 8 years. All 10 clusters had R0s ranging from 1.3 (0.4-2.5; 95% HPD) to 2.8 (0.6-6.5; 95% HPD). CONCLUSIONS: A high proportion of the most common TDR in subtype B infections in the United Kingdom is derived by onward transmission from treatment-naive patients.

Short TitleClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Alternate JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America