Résistance aux antirétroviraux
High prevalence of drug-resistant HIV-1 in treatment-naïve Europeans
1 November 2005 (Reuters-APM)
Réagir à cet article | Recommander cet article | Votez pour cet article
NEW YORK (Reuters Health) - In Europe, there is a high prevalence of drug-resistant HIV-1 variants in antiretroviral therapy-naïve individuals, investigators report in the September 15th Journal of Infectious Diseases.
The high prevalence of drug-resistant HIV-1 "should be taken into account when decisions are made about initial regimens for therapy-naïve individuals and about the selection of drugs for prophylaxis," the authors write.
Among 2,208 treatment-naïve patients recently and chronically infected with HIV-1 from 19 European countries during 1996-2002, the baseline rate of drug resistance mutations was 10.4%.
This suggests that one in 10 HIV-1-infected antiretroviral-naïve patients in Europe carry viruses with resistance to at least one antiretroviral drug, Dr. Annemarie M. Wensing from University Medical Center Utrecht in the Netherlands and colleagues point out.
Drug-resistant HIV-1 variants were significantly more common in recently than in chronically infected patients (13.5% vs 8.7%; p = 0.006) and in those patients infected with subtype B viruses than non-B viruses (12.9% vs 4.8%; p < 0.01).
In recently infected patients the risk of being infected with drug-resistant HIV was four times higher in patients with subtype B HIV-1 (16%) than in patients with non-B HIV-1 (4%).
"Interestingly, we noticed a consistent increase in baseline resistance in non-B viruses," Dr. Wensing and colleagues report. "This trend is consistent with the increasing number of patients identified with non-B viruses in Europe who are currently being exposed to therapy."
These findings, conclude the authors, "argue for (resistance) testing all drug-naïve patients and are of relevance when guidelines for management of postexposure prophylaxis and first-line therapy are updated."
The findings, they add, also support the need for ongoing surveillance of the spread of drug-resistant HIV-1, as well as the distribution of non-B viruses.
J Infect Dis 2005;192:958-966.