Ross Lisa L, Shortino Denise, Shaefer Mark S
1 ViiV Healthcare , Research Triangle Park, North Carolina.
2 PAREXEL International , Durham, North Carolina.
AIDS Res Hum Retroviruses. 2018 Aug;34(8):672-679. doi: 10.1089/AID.2017.0295. Epub 2018 Jun 5.
Pre-existing HIV drug resistance can jeopardize first-line antiretroviral therapy (ART) success. Changes in the prevalence of drug resistance-associated mutations (DRMs) were analyzed from HIV-infected, ART-naive, U.S. individuals seeking ART treatment from 2000 to 2009. HIV DRM data from 3,829 ART-naive subjects were analyzed by year of sample collection using International Antiviral Society-United States (IAS-USA) and World Health Organization (WHO) "surveillance" DRM definitions; minor IAS-USA-defined DRMs were excluded. IAS-USA DRM prevalence between 2000 and 2009 was 14%, beginning with 8% in 2000 and 13% in 2009. The greatest incidence was observed in 2007 (17%). Overall, IAS-USA-defined non-nucleoside reverse transcriptase inhibitor (NNRTI) DRMs were 9.5%; nucleoside reverse transcriptase inhibitor (NRTI): 4%, and major protease inhibitor (PI): 3%. The most frequently detected IAS-USA-defined DRMs by class were NNRTI: K103N/S (4%), NRTI: M41L (1.5%), and PI: L90M (1%). Overall, WHO-defined DRM prevalence was 13% (5% in 2000; 13% in 2009). By class, NNRTI prevalence was 6%, NRTI: 6%, and PI: 3.2%. The most frequent WHO-defined DRMs were NRTI: codon T215 (3.0%), NNRTI: K103N/S (4%), and PI: L90 (1%). WHO-defined NNRTI DRMs declined significantly (p = .0412) from 2007 to 2009. The overall prevalence of HIV-1 containing major IAS-USA or WHO-defined DRMs to ≥2 or ≥3 classes was 2% and <1%, respectively. The prevalence of HIV-1 with WHO-defined dual- or triple-class resistance significantly declined (p = .0461) from 2008 (4%) to 2009 (<1%). In this U.S. cohort, the prevalence of HIV-1 DRMs increased from 2000 onward, peaked between 2005 and 2007, and then declined between 2008 and 2009; the detection of WHO-defined dual- or triple-class DRM similarly decreased from 2008 to 2009.
预先存在的HIV耐药性可能会危及一线抗逆转录病毒疗法（ART）的成功。对2000年至2009年期间寻求ART治疗的未接受过ART治疗的美国HIV感染者中耐药相关突变（DRM）的流行率变化进行了分析。使用美国国际抗病毒协会（IAS-USA）和世界卫生组织（WHO）的“监测”DRM定义，按样本采集年份对3829名未接受过ART治疗的受试者的HIV DRM数据进行了分析；排除了IAS-USA定义的次要DRM。2000年至2009年期间，IAS-USA定义的DRM流行率为14%，2000年为8%，2009年为13%。2007年观察到最高发病率（17%）。总体而言，IAS-USA定义的非核苷类逆转录酶抑制剂（NNRTI）DRM为9.5%；核苷类逆转录酶抑制剂（NRTI）：4%，主要蛋白酶抑制剂（PI）：3%。按类别最常检测到的IAS-USA定义的DRM为NNRTI：K103N/S（4%），NRTI：M41L（1.5%），PI：L90M（1%）。总体而言，WHO定义的DRM流行率为13%（2000年为5%；2009年为13%）。按类别，NNRTI流行率为6%，NRTI：6%，PI：3.2%。最常见的WHO定义的DRM为NRTI：密码子T215（3.0%），NNRTI：K103N/S（4%），PI：L90（1%）。2007年至2009年期间，WHO定义的NNRTI DRM显著下降（p = 0.0412）。含有主要IAS-USA或WHO定义的DRM至≥2类或≥3类的HIV-1总体流行率分别为2%和<1%。具有WHO定义的双重或三重耐药性的HIV-1流行率从2008年（4%）至2009年（<1%）显著下降（p = 0.0461）。在这个美国队列中，HIV-1 DRM的流行率从2000年起上升，在2005年至2007年期间达到峰值，然后在2008年至2009年期间下降；2008年至2009年期间，WHO定义的双重或三重DRM的检测率同样下降。
