Prevalence of Transmitted Drug Resistance and Impact of Transmitted Resistance on Treatment Success in the German HIV-1 Seroconverter Cohort 英文参考文献.docVIP

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Prevalence of Transmitted Drug Resistance and Impact of Transmitted Resistance on Treatment Success in the German HIV-1 Seroconverter Cohort 英文参考文献.doc

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Prevalence of Transmitted Drug Resistance and Impact of Transmitted Resistance on Treatment Success in the German HIV-1 Seroconverter Cohort 英文参考文献

PrevalenceofTransmittedDrugResistanceandImpact ofTransmittedResistanceonTreatmentSuccessinthe GermanHIV-1SeroconverterCohort BarbaraBartmeyer1*.,ClaudiaKuecherer2*.,ClaudiaHouareau1,JohannaWerning1,KathrinKeeren2, SybilleSomogyi2,ChristianKollan1,HeikoJessen3,StephanDupke4,OsamahHamouda1,onbehalfof theGermanHIV-1SeroconverterStudyGroup 1HIV/AIDS,STDUnit,DepartmentInfectiousDiseaseEpidemiology,RobertKoch-Institute,Berlin,Germany,2ProjectHIVVariabilityandMolecularEpidemiology,Robert Koch-Institute,Berlin,Germany,3GemeinschaftspraxisJessen-Jessen-Stein,Berlin,Germany,4GemeinschaftspraxisDupke,Baumgarten,Carganico,Berlin,Germany Abstract Background:Theaimofthisstudyistoanalysetheprevalenceoftransmitteddrugresistance,TDR,andtheimpactofTDR ontreatmentsuccessintheGermanHIV-1SeroconverterCohort. Methods: Genotypic resistance analysis was performed in treatment-na?¨ve study patients whose sample was available 1,312/1,564 (83.9% October 2008). A genotypic resistance result was obtained for 1,276/1,312 (97.3%). The resistance associatedmutationswereidentifiedaccordingtothesurveillancedrugresistancemutationslistrecommendedfordrug- na?¨vepatients.Treatmentsuccesswasdeterminedasviralsuppressionbelow500copies/ml. Results:PrevalenceofTDRwasstableatahighlevelbetween1996and2007intheGermanHIV-1SeroconverterCohort (N=158/1,276; 12.4%; CIwilson 10.7–14.3; p for trend=0.25). NRTI resistance was predominant (7.5%) but decreased signifi- cantlyovertime(CIWilson:6.2–9.1,p for trend=0.02).NNRTIresistancetendedtoincreaseovertime(NNRTI:3.5%;CIWilson :2.6– 4.6;p for trend =0.07),whereasPIresistanceremainedstable(PI:3.0%;CIWilson:2.1–4.0;p for trend =0.24).Resistancetoall drugclasseswasfrequentlycausedbysingletonresistancemutations(NRTI55.6%,PI68.4%,NNRTI99.1%).Themajorityof NRTI-resistantstrains(79.8%)carriedresistance-associatedmutationsselectedbythethymidineanalogueszidovudineand stavudine.Preferably2NRTI/1PIrcombinationswereprescribedasfirstlineregimeninpatientswithresistantHIV