Transmitted Drug Resistance and Phylogenetic Relationships among Acute and Early Hiv-1 Infected Individuals in New York City.


Castor, D; Low, A; Evering, T; Karmon, S; Davis, B; Figueroa, A; Lamar, M; Garmon, D; Mehandru, S; Markowitz, M; (2012) Transmitted Drug Resistance and Phylogenetic Relationships among Acute and Early Hiv-1 Infected Individuals in New York City. Journal of acquired immune deficiency syndromes (1999). ISSN 1525-4135 DOI: https://doi.org/10.1097/QAI.0b013e31825a289b

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Abstract

: BACKGROUND:: Transmitted drug resistance (TDR) is critical to managing HIV-1 infected individuals as well as being a public health concern. Here we report on TDR prevalence and include analyses of phylogenetic clustering of HIV-1 in a predominantly MSM cohort diagnosed during acute / recent HIV-1 infection (AHI) in New York City. METHODS:: Genotypic resistance testing was conducted on plasma samples of 600 individuals with AHI (1995-2010). Sequences were used for resistance and phylogenetic analyses. Demographic and clinical data were abstracted from medical records. TDR was defined according to IAS USA and Stanford HIV database guidelines. Phylogenetic and other analyses were conducted using PAUP*4.0 and SAS, respectively. RESULTS:: The mean duration since HIV-1 infection was 66.5 days. TDR prevalence was 14.3%, and stably ranged between 10.8% and 21.6% (Ptrend=0.42). NRTI resistance declined from 15.5% to 2.7% over the study period (Ptrend=0.005). M41L (3.7%), T215Y (4.0%), and K103N/S (4.7%) were the most common mutations. K103N/S prevalence increased from 1.9% to 8.0% between 1995 and 2010 (Ptrend=0.04). Using a rigorous definition of clustering, 19.3% (112/581) of subtype B viral sequences co-segregated into transmission clusters, and clusters increased over time. There were fewer and smaller transmission clusters than had been reported in a similar cohort in Montreal, but similar to reports from elsewhere. CONCLUSIONS:: TDR is stable in this cohort and remains a significant concern to both individual patient management and the public health.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 22592583
Web of Science ID: 308352000007
URI: http://researchonline.lshtm.ac.uk/id/eprint/21040

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