Prevalence of drug-resistant HIV-1 variants in untreated individuals in Europe: Implications for clinical management

Annemarie M.J. Wensing, David A. Van De Vijver, Gioacchino Angarano, Birgitta Åsjö, Claudia Balotta, Enzo Boeri, Ricardo Camacho, Maire Laure Chaix, Dominique Costagliola, Andrea De Luca, Inge Derdelinckx, Zehava Grossman, Osamah Hamouda, Angelos Hatzakis, Robert Hemmer, Andy Hoepelman, Andrzej Horban, Klaus Korn, Claudia Kücherer, Thomas LeitnerClive Loveday, Eilidh MacRae, Irina Maljkovic, Carmen De Mendoza, Laurence Meyer, Claus Nielsen, Eline L. Op De Coul, Vidar Ormaasen, Dimitris Paraskevis, Luc Perrin, Elisabeth Puchhammer-Stöckl, Lidia Ruiz, Mika Salminen, Jean Claude Schmit, Francois Schneider, Rob Schuurman, Vincent Soriano, Grzegorz Stanczak, Maja Stanojevic, Anne Mieke Vandamme, Kristel Van Laethem, Michela Violin, Karin Wilbe, Sabine Yerly, Maurizio Zazzi, Charles A. Boucher*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

373 Citations (Scopus)


Background. Infection with drug-resistant human immunodeficiency virus type 1 (HIV-1) can impair the response to combination therapy. Widespread transmission of drug-resistant variants has the disturbing potential of limiting future therapy options and affecting the efficacy of postexposure prophylaxis. Methods. We determined the baseline rate of drug resistance in 2208 therapy-naive patients recently and chronically infected with HIV-1 from 19 European countries during 1996-2002. Results. In Europe, 1 of 10 antiretroviral-naive patients carried viruses with ≥1 drug-resistance mutation. Recently infected patients harbored resistant variants more often than did chronically infected patients (13.5% vs. 8.7%; P = .006). Non-B viruses (30%) less frequently carried resistance mutations than did subtype B viruses (4.8% vs. 12.9%; P < .01). Baseline resistance increased over time in newly diagnosed cases of non-B infection: from 2.0% (1/49) in 1996-1998 to 8.2% (16/194) in 2000-2001. Conclusions. Drug-resistant variants are frequently present in both recently and chronically infected therapy-naive patients. Drug-resistant variants are most commonly seen in patients infected with subtype B virus, probably because of longer exposure of these viruses to drugs. However, an increase in baseline resistance in non-B viruses is observed. These data argue for testing all drug-naive patients and are of relevance when guidelines for management of postexposure prophylaxis and first-line therapy are updated.

Original languageEnglish
Pages (from-to)958-966
Number of pages9
JournalJournal of Infectious Diseases
Issue number6
Publication statusPublished - 15 Sept 2005
Externally publishedYes


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