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Dynamics and phylogenetic relationships of HIV-1 transmitted drug resistance according to subtype in Italy over the years 2000-14.
Fabeni, L; Alteri, C; Di Carlo, D; Orchi, N; Carioti, L; Bertoli, A; Gori, C; Forbici, F; Continenza, F; Maffongelli, G; Pinnetti, C; Vergori, A; Mondi, A; Ammassari, A; Borghi, V; Giuliani, M; De Carli, G; Pittalis, S; Grisetti, S; Pennica, A; Mastroianni, C M; Montella, F; Cristaudo, A; Mussini, C; Girardi, E; Andreoni, M; Antinori, A; Ceccherini-Silberstein, F; Perno, C F; Santoro, M M.
Affiliation
  • Fabeni L; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Alteri C; University of Rome Tor Vergata, Rome, Italy.
  • Di Carlo D; University of Rome Tor Vergata, Rome, Italy.
  • Orchi N; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Carioti L; University of Rome Tor Vergata, Rome, Italy.
  • Bertoli A; University of Rome Tor Vergata, Rome, Italy.
  • Gori C; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Forbici F; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Continenza F; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Maffongelli G; University Hospital Tor Vergata, Rome, Italy.
  • Pinnetti C; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Vergori A; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Mondi A; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Ammassari A; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Borghi V; Modena University Hospital, Modena, Italy.
  • Giuliani M; San Gallicano Dermatological Institute, IRCCS, Rome, Italy.
  • De Carli G; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Pittalis S; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Grisetti S; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Pennica A; S. Andrea Hospital, Rome, Italy.
  • Mastroianni CM; Sapienza University, Latina, Italy.
  • Montella F; S. Giovanni Addolorata Hospital, Rome, Italy.
  • Cristaudo A; San Gallicano Dermatological Institute, IRCCS, Rome, Italy.
  • Mussini C; Modena University Hospital, Modena, Italy.
  • Girardi E; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Andreoni M; University Hospital Tor Vergata, Rome, Italy.
  • Antinori A; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Ceccherini-Silberstein F; University of Rome Tor Vergata, Rome, Italy.
  • Perno CF; National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy.
  • Santoro MM; University of Rome Tor Vergata, Rome, Italy.
J Antimicrob Chemother ; 72(10): 2837-2845, 2017 10 01.
Article in En | MEDLINE | ID: mdl-29091206
ABSTRACT

Background:

Transmitted drug-resistance (TDR) remains a critical aspect for the management of HIV-1-infected individuals. Thus, studying the dynamics of TDR is crucial to optimize HIV care.

Methods:

In total, 4323 HIV-1 protease/reverse-transcriptase sequences from drug-naive individuals diagnosed in north and central Italy between 2000 and 2014 were analysed. TDR was evaluated over time. Maximum-likelihood and Bayesian phylogenetic trees with bootstrap and Bayesian-probability supports defined transmission clusters.

Results:

Most individuals were males (80.2%) and Italian (72.1%), with a median (IQR) age of 37 (30-45) years. MSM accounted for 42.2% of cases, followed by heterosexuals (36.4%). Non-B subtype infections accounted for 30.8% of the overall population and increased over time (<2005-14 19.5%-38.5%, P < 0.0001), particularly among Italians (<2005-14 6.5%-28.8%, P < 0.0001). TDR prevalence was 8.8% and increased over time in non-B subtypes (<2005-14 2%-7.1%, P = 0.018). Overall, 467 transmission clusters (involving 1207 individuals; 27.9%) were identified. The prevalence of individuals grouping in transmission clusters increased over time in both B (<2005-14 12.9%-33.5%, P = 0.001) and non-B subtypes (<2005-14 18.4%-41.9%, P = 0.006). TDR transmission clusters were 13.3% within the overall cluster observed and dramatically increased in recent years (<2005-14 14.3%-35.5%, P = 0.005). This recent increase was mainly due to non-B subtype-infected individuals, who were also more frequently involved in large transmission clusters than those infected with a B subtype [median number of individuals in transmission clusters 7 (IQR 6-19) versus 4 (3-4), P = 0.047].

Conclusions:

The epidemiology of HIV transmission changed greatly over time; the increasing number of transmission clusters (sometimes with drug resistance) shows that detection and proper treatment of the multi-transmitters is a major target for controlling HIV spread.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: HIV Infections / HIV-1 / Drug Resistance, Viral Type of study: Prevalence_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: En Journal: J Antimicrob Chemother Year: 2017 Document type: Article Affiliation country: Italia

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: HIV Infections / HIV-1 / Drug Resistance, Viral Type of study: Prevalence_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: En Journal: J Antimicrob Chemother Year: 2017 Document type: Article Affiliation country: Italia