BACKGROUND: Infection with drug-resistant human immunodeficiency virus type 1 (HIV-1) can impair the response to combination therapy. Widespread transmission of drug-resistant variants has the disturbing potential of limiting future therapy options and affecting the efficacy of postexposure prophylaxis. METHODS: We determined the baseline rate of drug resistance in 2208 therapy-naive patients recently and chronically infected with HIV-1 from 19 European countries during 1996-2002. RESULTS: In Europe, 1 of 10 antiretroviral-naive patients carried viruses with > or = 1 drug-resistance mutation. Recently infected patients harbored resistant variants more often than did chronically infected patients (13.5% vs. 8.7%; P=.006). Non-B viruses (30%) less frequently carried resistance mutations than did subtype B viruses (4.8% vs. 12.9%; P<.01). Baseline resistance increased over time in newly diagnosed cases of non-B infection: from 2.0% (1/49) in 1996-1998 to 8.2% (16/194) in 2000-2001. CONCLUSIONS: Drug-resistant variants are frequently present in both recently and chronically infected therapy-naive patients. Drug-resistant variants are most commonly seen in patients infected with subtype B virus, probably because of longer exposure of these viruses to drugs. However, an increase in baseline resistance in non-B viruses is observed. These data argue for testing all drug-naive patients and are of relevance when guidelines for management of postexposure prophylaxis and first-line therapy are updated.
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|Titolo:||Prevalence of drug-resistant HIV-1 variants in untreated individuals in Europe: implications for clinical management.|
|Rivista:||THE JOURNAL OF INFECTIOUS DISEASES|
|Citazione:||Wensing, A., VAN DE VIJVER, D.a., Angarano, G., Sj, B., Balotta, C., Boeri, E., et al. (2005). Prevalence of drug-resistant HIV-1 variants in untreated individuals in Europe: implications for clinical management. THE JOURNAL OF INFECTIOUS DISEASES, 192, 958-966.|
|Appare nelle tipologie:||1.1 Articolo in rivista|