Paraskevis D, Magiorkinis E, Katsoulidou A, Hatzitheodorou E, Antoniadou A, Papadopoulos A, Poulakou G, Paparizos V, Botsi C, Stavrianeas N, Lelekis M, Chini M, Gargalianos P, Magafas N, Lazanas M, Chryssos G, Petrikkos G, Panos G, Kordossis T, Theodoridou M, Sypsa V, Hatzakis A
Department of Hygiene and Epidemiology, Athens University Medical School, Mikras Asias 75, GR-11527 Athens, Greece.
Virus Res. 2005 Sep;112(1-2):115-22. doi: 10.1016/j.virusres.2005.03.004. Epub 2005 Apr 8.
The prevalence of HIV-1 drug resistance mutations in naïve patients has been previously shown to differ greatly with the geographic origin. The purpose of this study was to prospectively estimate the prevalence of HIV-1 drug resistance in Greece by analyzing a representative sample of newly HIV-1 diagnosed patients, as part of the SPREAD collaborative study. Protease (PR) and partial reverse transcriptase (RT) sequences were determined from 101 newly diagnosed HIV-1 patients, in Greece, during the period September 2002--August 2003, representing one-third of the total newly diagnosed HIV-1 patients in the same time period. The prevalence of HIV-1 drug resistance was estimated according to the IAS-USA mutation table taking into account all mutations in RT and only major mutations in PR region. The overall prevalence of resistance was 9% [95% confidence interval (CI): 4.2--16.2%]. The prevalence of mutations associated with resistance to NRTIs was 5% (95% CI: 1.6--11.2%), for NNRTIs was 4% (95% CI: 1.1--9.8%), while no major resistance mutations were found in PR. No multi-class resistance was detected in the study population. The prevalence of resistant mutations in the recent seroconverters was 22%. For two individuals, there was clear evidence for transmitted resistance based on epidemiological information for a known source of HIV-1 transmission. The prevalence of the HIV-1 non-B subtypes and recombinants was 52%.
先前研究表明，初治患者中HIV-1耐药突变的流行率因地理区域的不同而有很大差异。本研究的目的是通过分析新诊断的HIV-1患者的代表性样本，前瞻性地评估希腊HIV-1耐药情况，这是SPREAD合作研究的一部分。2002年9月至2003年8月期间，从希腊101例新诊断的HIV-1患者中测定了蛋白酶（PR）和部分逆转录酶（RT）序列，这些患者占同期新诊断HIV-1患者总数的三分之一。根据IAS-USA突变表，考虑RT中的所有突变以及PR区域仅主要突变，估计HIV-1耐药流行率。总体耐药流行率为9%[95%置信区间（CI）：4.2-16.2%]。与核苷类逆转录酶抑制剂（NRTIs）耐药相关的突变流行率为5%（95%CI：1.6-11.2%），与非核苷类逆转录酶抑制剂（NNRTIs）耐药相关的突变流行率为4%（95%CI：1.1-9.8%），而PR中未发现主要耐药突变。研究人群中未检测到多类耐药。近期血清转化者中耐药突变的流行率为22%。根据已知HIV-1传播源的流行病学信息，有两名个体有明确的传播耐药证据。HIV-1非B亚型和重组体的流行率为52%。
