Trends in Transmission of Drug Resistance and Prevalence of Non-B Subtypes in Patients with Acute or Recent HIV-1 Infection in Barcelona in the Last 16 Years (1997-2012)

PLoS One. 2015 Jun 3;10(6):e0125837. doi: 10.1371/journal.pone.0125837. eCollection 2015.

Abstract

Objectives: To evaluate the prevalence of transmitted drug resistance (TDR) and non-B subtypes in patients with acute/recent HIV-1 infection in Barcelona during the period 1997-2012.

Methods: Patients from the "Hospital Clínic Primary HIV-1 Infection Cohort" with a genotyping test performed within 180 days of infection were included. The 2009 WHO List of Mutations for Surveillance of Transmitted HIV-1 Drug Resistance was used for estimating the prevalence of TDR and phylogenetic analysis for subtype determination.

Results: 189 patients with acute/recent HIV-1 infection were analyzed in 4 time periods (1997-2000, n=28; 2001-4, n=42; 2005-8, n=55 and 2009-12, n=64). The proportion of patients with acute/recent HIV-1 infection with respect to the total of newly HIV-diagnosed patients in our center increased over the time and was 2.18%, 3.82%, 4.15% and 4.55% for the 4 periods, respectively (p=0.005). The global prevalence of TDR was 9%, or 17.9%, 9.5%, 3.6% and 9.4% by study period (p=0.2). The increase in the last period was driven by protease-inhibitor and nucleoside-reverse-transcriptase-inhibitor resistance mutations while non-nucleoside-reverse-transcriptase inhibitor TDR and TDR of more than one family decreased. The overall prevalence of non-B subtypes was 11.1%, or 0%, 4.8%, 9.1% and 20.3 by study period (p=0.01). B/F recombinants, B/G recombinants and subtype F emerged in the last period. We also noticed an increase in the number of immigrant patients (p=0.052). The proportion of men-who-have-sex-with-men (MSM) among patients with acute/recent HIV-1 infection increased over the time (p=0.04).

Conclusions: The overall prevalence of TDR in patients with acute/recent HIV-1 infection in Barcelona was 9%, and it has stayed relatively stable in recent years. Non-B subtypes and immigrants proportions progressively increased.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Drug Resistance, Viral / genetics*
  • Female
  • HIV Infections* / epidemiology
  • HIV Infections* / genetics
  • HIV Infections* / transmission
  • HIV-1* / genetics
  • HIV-1* / pathogenicity
  • Humans
  • Male
  • Middle Aged
  • Mutation
  • Phylogeny*
  • Prevalence
  • Retrospective Studies
  • Spain / epidemiology

Grants and funding

This work was partially supported by a grant from the “Red Temática Cooperativa de Grupos de Investigación en Sida (RIS)” of the Fondo de Investigación Sanitaria (FIS) (ISCIII-RETIC RD06/006), Instituto de Salud Carlos III, Madrid, Spain. Anabel Romero is part of the “Ciber de Epidemiología y Salud Pública (CIBERESP)” and the Doctoral Program in Public Health at the Department of Pediatrics, Obstetrics, and Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain. Dr. David Nicolas developed this work in the framework of a post-residency Scholarship Ajuts a la recerca ‘Josep Fonts 2014’, Hospital Clinic, Barcelona, Spain. Dr. Juan Ambrosioni developed this work in the framework of a ‘Juan de la Cierva 2012’ post-doctoral program, Ministerio de Competitividad, Spain. This work was also the basis for Dr. Ambrosioni’s thesis, Master of AIDS, University of Barcelona, Spain. Dr. M. López-Diéguez and Dr. Fernando Agüero held a Rio Hortega Research Grant from the “Instituto de Salud Carlos III” and the “Ministerio de Economia and Competitividad”, Madrid (Spain) whilst this work was being developed. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.