Paraskevis Dimitrios, Kostaki Evangelia, Gargalianos Panagiotis, Xylomenos Georgios, Lazanas Marios, Chini Maria, Skoutelis Athanasios, Papastamopoulos Vasileios, Paraskeva Dimitra, Antoniadou Anastasia, Papadopoulos Antonios, Psichogiou Mina, Daikos Georgios L, Chrysos Georgios, Paparizos Vasileios, Kourkounti Sofia, Sambatakou Helen, Sipsas Nikolaos V, Lada Malvina, Panagopoulos Periklis, Maltezos Efstratios, Drimis Stylianos, Hatzakis Angelos
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece.
1st Department of Internal Medicine, G. Genimatas GH, 11527 Athens, Greece.
Genes (Basel). 2017 Nov 13;8(11):322. doi: 10.3390/genes8110322.
The presence of human immunodeficiency virus type 1 (HIV-1) drug resistance among drug-naïve patients remains stable, although the proportion of patients with virological failure to therapy is decreasing. The dynamics of transmitted resistance among drug-naïve patients remains largely unknown. The prevalence of non-nucleoside reverse transcriptase inhibitors (NNRTI) resistance was 16.9% among treatment-naïve individuals in Greece. We aimed to investigate the transmission dynamics and the effective reproductive number () of the locally transmitted NNRTI resistance. We analyzed sequences with dominant NNRTI resistance mutations (E138A and K103N) found within monophyletic clusters (local transmission networks (LTNs)) from patients in Greece. For the K103N LTN, the was >1 between 2008 and the first half of 2013. For all E138A LTNs, the was >1 between 1998 and 2015, except the most recent one (E138A_4), where the was >1 between 2006 and 2011 and approximately equal to 1 thereafter. K103N and E138A_4 showed similar characteristics with a more recent origin, higher during the first years of the sub-epidemics, and a declining trend in the number of transmissions during the last two years. In the remaining LTNs the epidemic was still expanding. Our study highlights the added value of molecular epidemiology to public health.
在初治患者中，1型人类免疫缺陷病毒（HIV-1）耐药性的存在保持稳定，尽管治疗出现病毒学失败的患者比例在下降。初治患者中传播性耐药的动态变化在很大程度上仍不清楚。在希腊，初治个体中非核苷类逆转录酶抑制剂（NNRTI）耐药的患病率为16.9%。我们旨在研究本地传播的NNRTI耐药性的传播动态和有效再生数（）。我们分析了来自希腊患者单系簇（本地传播网络（LTN））中发现的具有主要NNRTI耐药突变（E138A和K103N）的序列。对于K103N LTN，在2008年至2013年上半年期间，>1。对于所有E138A LTN，在1998年至2015年期间，>1，但最近的一个（E138A_4）除外，在该簇中，2006年至2011年期间>1，此后约等于1。K103N和E138A_4表现出相似的特征，起源较近，在亚流行的最初几年中较高，在过去两年中传播数量呈下降趋势。在其余的LTN中，疫情仍在扩大。我们的研究强调了分子流行病学对公共卫生的附加价值。
