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首页> 外文期刊>AIDS Research and Human Retroviruses >Short communication: Transmitted drug resistance and molecular epidemiology in antiretroviral naive HIV type 1-infected patients in Rhode Island.
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Short communication: Transmitted drug resistance and molecular epidemiology in antiretroviral naive HIV type 1-infected patients in Rhode Island.

机译：简短交流：罗德岛州1型抗逆转录病毒初次感染HIV的患者的传播耐药性和分子流行病学。

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摘要

Transmission of HIV-1 drug resistance has important clinical and epidemiological consequences including earlier treatment failure and forward transmission of resistance strains in high-risk groups. To evaluate the prevalence and molecular epidemiology of transmitted drug resistance in Rhode Island, we collected genotypic, demographic, clinical, and laboratory data from treatment-naive individuals presenting to the largest outpatient HIV clinic in the state from January 2007 to November 2007. Sequences from 35 treatment-naive individuals were available, 83% of whom were men who had sex with men (MSM). All sequences were HIV-1 subtype B. Drug resistance mutations were identified in 7/35 [20%; 95% confidence interval (CI), 0.08-0.37] patients, six of whom had K103N. Two phylogenetic transmission clusters were found, involving 17% (6/35) of individuals, three in each cluster. We did not find an association between belonging to a cluster and age, gender, AIDS-defining illness, CD4 cell count, or viral load. Drug resistance mutations were more commonly observed in transmission clusters (p = 0.08). Individuals in one cluster all had K103N and were MSM who had attended local bathhouses. Individuals forming clusters were significantly more likely to have visited a bathhouse compared to nonclusters (p = 0.02). The prevalence of transmitted drug resistance in Rhode Island is high, further justifying genotypic testing on presentation to care and prior to treatment initiation. Molecular epidemiological analysis and association of resistance with phylogenetic networks using data obtained for clinical purposes may serve as useful tools for the prevention of drug resistance transmission and for contact tracing.
机译：HIV-1耐药性的传播具有重要的临床和流行病学后果，包括早期治疗失败和高危人群中耐药菌株的正向传播。为了评估罗得岛州耐药菌传播的患病率和分子流行病学，我们收集了2007年1月至2007年11月在该州最大的门诊HIV诊所就诊的未接受过治疗的个体的基因型，人口统计学，临床和实验室数据。共有35名未接受过治疗的个体，其中83％是与男性发生性关系（MSM）的男性。所有序列均为HIV-1亚型B。在7/35中鉴定出耐药性突变[20％; 95％的置信区间（CI），0.08-0.37]患者，其中6例患有K103N。发现了两个系统发育传播簇，涉及17％（6/35）的个体，每个簇中三个。我们没有发现属于人群的人群与年龄，性别，定义艾滋病的疾病，CD4细胞计数或病毒载量之间存在关联。在传播群中更常见的是耐药性突变（p = 0.08）。一个集群中的所有人都拥有K103N，并且是参加过当地澡堂的MSM。与非集群相比，形成集群的个体访问澡堂的可能性更高（p = 0.02）。在罗德岛州，耐药菌的传播率很高，这进一步证明了在就诊时和治疗开始前进行基因型检测是合理的。分子流行病学分析以及使用为临床目的而获得的数据将耐药性与系统进化网络联系起来，可作为预防耐药性传播和接触追踪的有用工具。

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