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Recent trends and patterns in HIV ‐1 transmitted drug resistance in the United Kingdom
Author(s) -
Tostevin A,
White E,
Dunn D,
Croxford S,
Delpech V,
Williams I,
Asboe D,
Pozniak A,
Churchill D,
Geretti AM,
Pillay D,
Sabin C,
LeighBrown A,
Smit E
Publication year - 2017
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12414
Subject(s) - rilpivirine , medicine , drug resistance , efavirenz , dolutegravir , virology , integrase inhibitor , hiv drug resistance , resistance mutation , reverse transcriptase inhibitor , reverse transcriptase , logistic regression , human immunodeficiency virus (hiv) , viral load , antiretroviral therapy , genetics , polymerase chain reaction , biology , gene
Objectives Transmission of drug‐resistant HIV ‐1 has decreased in the UK since the early 2000s. This analysis reports recent trends and characteristics of transmitted drug resistance ( TDR ) in the UK from 2010 to 2013. Methods Resistance tests conducted in antiretroviral treatment ( ART )‐naïve individuals between 2010 and 2013 were analysed for the presence of transmitted drug resistance mutations ( TDRM s), defined as any mutations from a modified 2009 World Health Organization surveillance list, or a modified 2013 International Antiviral Society‐ USA list for integrase tests. Logistic regression was used to examine associations between demographics and the prevalence of TDRM s. Results TDRM s were observed in 1223 (7.5%) of 16 425 individuals; prevalence declined from 8.1% in 2010 to 6.6% in 2013 ( P = 0.02). The prevalence of TDRM s was higher among men who have sex with men ( MSM ) compared with heterosexual men and women (8.7% versus 6.4%, respectively) with a trend for decreasing TDRM s among MSM ( P = 0.008) driven by a reduction in nucleoside reverse transcriptase inhibitor ( NRTI )‐related mutations. The most frequently detected TDRM s were K103N (2.2%), T215 revertants (1.6%), M41L (0.9%) and L90M (0.7%). Predicted phenotypic resistance to first‐line ART was highest to the nonnucleoside reverse transcriptase inhibitors ( NNRTI s) rilpivirine and efavirenz (6.2% and 3.4%, respectively) but minimal to NRTI s, including tenofovir, and protease inhibitors ( PI s). No major integrase TDRM s were detected among 101 individuals tested while ART ‐naïve. Conclusions We observed a decrease in TDRM s in recent years. However, this was confined to the MSM population and rates remained stable in those with heterosexually acquired HIV infection. Resistance to currently recommended first‐line ART , including integrase inhibitors, remained reassuringly low.