In Europe has increased the number of resistant strains of several HIV subtypes
Frequency of detection of HIV-1 mutations associated with antiretroviral drug resistance (ART) among Western Europeans between 2010 and 2016. did not show significant changes, scientists established. However, this finding does not affect cases of the drug-resistant strain of HIV-1 non-B subtypes. Among them, specialists saw a certain increase, which, according to them, runs the risk of gaining even more pronounced dynamics if people with HIV do not take effective ART. The results of the study were published this week in the Journal of Antimicrobial Chemotherapy.
Although HIV incidence and AIDS mortality declined markedly with increased access to antiretroviral therapy, there was a risk of a surge in resistant strains of HIV and a decrease in the effectiveness of first-line drugs used among “naive” patients.
Given this, a group of specialists from France conducted a study of the prevalence of mutations associated with resistance to traditionally used among HIV-positive drugs.
Using data from 660 people from 33 clinical centers involved in HIV treatment in 2015-2016, specialists evaluated the number of PLHIV with mutations associated with drug resistance. After that, the results were compared with the data of the 2010-2011 survey, in which 661 people took part.
The basic characteristics of the population between 2010-2011 and 2015-2016. turned out to be as follows:
- The number of CD4 cells: 394 / mm3 and 350 / mm3 (P = 0.056),
- Plasma HIV-1 RNA: 4.6 log10 and 4.6 log10 (P = 0.360).
In 2015-2016 the total prevalence of mutations associated with antiretroviral resistance was 10.8%, which was comparable with the results of a previous survey conducted in 2010-2011. Then this indicator was 9.0% (P = .269). These numbers were also similar to the prevalence of drug-resistant strains of the virus in the United States and Canada.
However, the incidence of non-subtype B HIV-1 cases increased from 42.9% in 2010–2011 to 54.8% in 2015–2016 (P <0.001).
Multivariate analysis showed that the group of men infected with subtype B had the highest risk of drug-resistant mutations, and the likelihood of becoming infected with a resistant strain of HIV was 2.2 times higher than in men with a subtype of non-B (adjusted ratio chances are 2.25).
In addition, subtype B MSM accounted for 76.5% of the male population with HIV in 2010–2011 and 79.8% in 2015–2016.
Note that the prevalence of the virus with mutations associated with drug resistance from the classes of protease inhibitors or reverse transcriptase did not show a significant increase compared with the level of 2010-2011.
Thus, the authors of the study came to the conclusion that "the data obtained emphasize the importance of regular testing for genotypic resistance when diagnosing and / or before starting ART."
According to them, the results also confirm the need for surveillance of [mutations associated with drug resistance] for all classes of therapy.