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Emergence of Acquired HIV-1 Drug Resistance Almost Stopped in Switzerland: A 15-Year Prospective Cohort Analysis

Scherrer, A. U. and von Wyl, V. and Yang, W. L. and Kouyos, R. D. and Boni, J. and Yerly, S. and Klimkait, T. and Aubert, V. and Cavassini, M. and Battegay, M. and Furrer, H. and Calmy, A. and Vernazza, P. and Bernasconi, E. and Gunthard, H. F. and the Swiss, H. I. V. Cohort Study and Aubert, V. and Battegay, M. and Bernasconi, E. and Boni, J. and Braun, D. L. and Bucher, H. C. and Burton-Jeangros, C. and Calmy, A. and Cavassini, M. and Dollenmaier, G. and Egger, M. and Elzi, L. and Fehr, J. and Fellay, J. and Furrer, H. and Fux, C. A. and Gorgievski, M. and Gunthard, H. and Haerry, D. and Hasse, B. and Hirsch, H. H. and Hoffmann, M. and Hosli, I. and Kahlert, C. and Kaiser, L. and Keiser, O. and Klimkait, T. and Kouyos, R. and Kovari, H. and Ledergerber, B. and Martinetti, G. and Martinez de Tejada, B. and Marzolini, C. and Metzner, K. and Muller, N. and Nadal, D. and Nicca, D. and Pantaleo, G. and Rauch, A. and Regenass, S. and Rudin, C. and Schoni-Affolter, F. and Schmid, P. and Speck, R. and Stockle, M. and Tarr, P. and Trkola, A. and Vernazza, P. and Weber, R. and Yerly, S.. (2016) Emergence of Acquired HIV-1 Drug Resistance Almost Stopped in Switzerland: A 15-Year Prospective Cohort Analysis. Clin Infect Dis, 62 (10). pp. 1310-1317.

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Official URL: https://edoc.unibas.ch/61879/

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Abstract

BACKGROUND: Drug resistance is a major barrier to successful antiretroviral treatment (ART). Therefore, it is important to monitor time trends at a population level. METHODS: We included 11 084 ART-experienced patients from the Swiss HIV Cohort Study (SHCS) between 1999 and 2013. The SHCS is highly representative and includes 72% of patients receiving ART in Switzerland. Drug resistance was defined as the presence of >/=1 major mutation in a genotypic resistance test. To estimate the prevalence of drug resistance, data for patients with no resistance test was imputed based on the patient's risk of harboring drug-resistant viruses. RESULTS: The emergence of new drug resistance mutations declined dramatically from 401 to 23 patients between 1999 and 2013. The upper estimated prevalence limit of drug resistance among ART-experienced patients decreased from 57.0% in 1999 to 37.1% in 2013. The prevalence of 3-class resistance decreased from 9.0% to 4.4% and was always <0.4% for patients who initiated ART after 2006. Most patients actively participating in the SHCS in 2013 with drug-resistant viruses initiated ART before 1999 (59.8%). Nevertheless, in 2013, 94.5% of patients who initiated ART before 1999 had good remaining treatment options based on Stanford algorithm. CONCLUSIONS: Human immunodeficiency virus type 1 drug resistance among ART-experienced patients in Switzerland is a well-controlled relic from the era before combination ART. Emergence of drug resistance can be virtually stopped with new potent therapies and close monitoring.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Division of Medical Microbiology > Molecular Virology (Klimkait)
03 Faculty of Medicine > Departement Biomedizin > Division of Medical Microbiology > Transplantation Virology (Hirsch)
UniBasel Contributors:Hirsch, Hans H. and Klimkait, Thomas
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1537-6591 (Electronic)1058-4838 (Linking)
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:31 May 2020 21:22
Deposited On:31 May 2020 21:22

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