Transmission of drug-resistant HIV-1 in Europe remains limited to single classes

Annemarie M.J. Wensing, Jurgen Vercauteren, David A. Van De Vijver, Jan Albert, Birgitta Åsjö, Claudia Balotta, Ricardo Camacho, Suzie Coughlan, Zehava Grossman, Andrzej Horban, Claudia Kücherer, Claus Nielsen, Dimitris Paraskevis, Wei C. Loke, Gabrielle Poggensee, Elisabeth Puchhammer-Stöckl, Chiara Riva, Lidia Ruiz, Jean Claude Schmit, Rob SchuurmanMika Salminen, Anders Sonnerborg, Maja Stanojevic, Daniel Struck, Anne Mieke Vandamme, Charles A.B. Boucher

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121 Citations (Scopus)


BACKGROUND: The spread of drug-resistant HIV-1 might compromise the future success of current first-line regimens. OBJECTIVE: To analyse the extent and impact of transmission of drug-resistant HIV-1 variants in Europe. DESIGN AND METHODS: The European prospective programme (SPREAD) collected demographic, clinical and virological data from 1245 HIV-1-infected individuals in 17 countries diagnosed in 2002-2003. The potential impact of transmitted drug resistance mutations (TDRMs) on therapy response was determined by using genotypic interpretation algorithms. RESULTS: The overall prevalence of viruses with drug-resistance mutations was 9.1% [96/1050; 95% confidence interval: 7.5-11.1]. The majority (71%) harboured only a single amino acid substitution with limited effect on predicted drug susceptibility. Mutations associated with resistance to nucleoside reverse transcriptase inhibitors were observed most frequently [57/1050 (5.4%)], followed by mutations related to protease inhibitors [32/1050 (3.0%)] and mutations related to non-nucleoside reverse transcriptase inhibitors (NNRTIs) [27/1050 (2.6%)].In some cases, however, resistance was quite extensive. Four individuals were infected with viruses with reduced susceptibility to all nucleoside reverse transcriptase inhibitors, 3 to all protease inhibitors and 20 to both NNRTIs. Remarkably, in one individual, the resistance pattern was so extensive that none of the available current antiretroviral drugs was predicted to be fully active. CONCLUSION: The prevalence of TDRM-HIV is quite prominent (9.1%) but did not increase in comparison with a large retrospective European study. Particularly the presence of single NNRTI mutations may impact the efficacy of the first-line regimens. Continuous prospective monitoring remains indicated to explore the patterns and factors contributing to the transmission of TDRMs as well as the potential clinical consequences.

Original languageEnglish
Pages (from-to)625-635
Number of pages11
Issue number5
Publication statusPublished - Mar 2008
Externally publishedYes


  • Europe
  • HIV-1
  • Resistance
  • Transmission


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