Clinically relevant transmitted drug resistance to first line antiretroviral drugs and implications for recommendations.
<h4>Background</h4>The aim was to analyse trends in clinically relevant resistance to first-line antiretroviral drugs in Spain, applying the Stanford algorithm, and to compare these results with reported Transmitted Drug Resistance (TDR) defined by the 2009 update of the WHO SDRM list.&l...
Guardado en:
| Autores principales: | , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Public Library of Science (PLoS)
2014
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/14b946dacba94b19a7ee357758c6911c |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:14b946dacba94b19a7ee357758c6911c |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:14b946dacba94b19a7ee357758c6911c2021-11-18T08:27:47ZClinically relevant transmitted drug resistance to first line antiretroviral drugs and implications for recommendations.1932-620310.1371/journal.pone.0090710https://doaj.org/article/14b946dacba94b19a7ee357758c6911c2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24637804/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The aim was to analyse trends in clinically relevant resistance to first-line antiretroviral drugs in Spain, applying the Stanford algorithm, and to compare these results with reported Transmitted Drug Resistance (TDR) defined by the 2009 update of the WHO SDRM list.<h4>Methods</h4>We analysed 2781 sequences from ARV naive patients of the CoRIS cohort (Spain) between 2007-2011. Using the Stanford algorithm "Low-level resistance", "Intermediate resistance" and "High-level resistance" categories were considered as "Resistant".<h4>Results</h4>70% of the TDR found using the WHO list were relevant for first-line treatment according to the Stanford algorithm. A total of 188 patients showed clinically relevant resistance to first-line ARVs [6.8% (95%Confidence Interval: 5.8-7.7)], and 221 harbored TDR using the WHO list [7.9% (6.9-9.0)]. Differences were due to a lower prevalence in clinically relevant resistance for NRTIs [2.3% (1.8-2.9) vs. 3.6% (2.9-4.3) by the WHO list] and PIs [0.8% (0.4-1.1) vs. 1.7% (1.2-2.2)], while it was higher for NNRTIs [4.6% (3.8-5.3) vs. 3.7% (3.0-4.7)]. While TDR remained stable throughout the study period, clinically relevant resistance to first line drugs showed a significant trend to a decline (p = 0.02).<h4>Conclusions</h4>Prevalence of clinically relevant resistance to first line ARVs in Spain is decreasing, and lower than the one expected looking at TDR using the WHO list. Resistance to first-line PIs falls below 1%, so the recommendation of screening for TDR in the protease gene should be questioned in our setting. Cost-effectiveness studies need to be carried out to inform evidence-based recommendations.Susana MongeVicente GuillotMarta AlvarezNatalia ChuecaNatalia StellaAlejandro PeñaRafael DelgadoJuan CórdobaAntonio AguileraCarmen VidalFederico GarcíaCoRISPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 3, p e90710 (2014) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Susana Monge Vicente Guillot Marta Alvarez Natalia Chueca Natalia Stella Alejandro Peña Rafael Delgado Juan Córdoba Antonio Aguilera Carmen Vidal Federico García CoRIS Clinically relevant transmitted drug resistance to first line antiretroviral drugs and implications for recommendations. |
| description |
<h4>Background</h4>The aim was to analyse trends in clinically relevant resistance to first-line antiretroviral drugs in Spain, applying the Stanford algorithm, and to compare these results with reported Transmitted Drug Resistance (TDR) defined by the 2009 update of the WHO SDRM list.<h4>Methods</h4>We analysed 2781 sequences from ARV naive patients of the CoRIS cohort (Spain) between 2007-2011. Using the Stanford algorithm "Low-level resistance", "Intermediate resistance" and "High-level resistance" categories were considered as "Resistant".<h4>Results</h4>70% of the TDR found using the WHO list were relevant for first-line treatment according to the Stanford algorithm. A total of 188 patients showed clinically relevant resistance to first-line ARVs [6.8% (95%Confidence Interval: 5.8-7.7)], and 221 harbored TDR using the WHO list [7.9% (6.9-9.0)]. Differences were due to a lower prevalence in clinically relevant resistance for NRTIs [2.3% (1.8-2.9) vs. 3.6% (2.9-4.3) by the WHO list] and PIs [0.8% (0.4-1.1) vs. 1.7% (1.2-2.2)], while it was higher for NNRTIs [4.6% (3.8-5.3) vs. 3.7% (3.0-4.7)]. While TDR remained stable throughout the study period, clinically relevant resistance to first line drugs showed a significant trend to a decline (p = 0.02).<h4>Conclusions</h4>Prevalence of clinically relevant resistance to first line ARVs in Spain is decreasing, and lower than the one expected looking at TDR using the WHO list. Resistance to first-line PIs falls below 1%, so the recommendation of screening for TDR in the protease gene should be questioned in our setting. Cost-effectiveness studies need to be carried out to inform evidence-based recommendations. |
| format |
article |
| author |
Susana Monge Vicente Guillot Marta Alvarez Natalia Chueca Natalia Stella Alejandro Peña Rafael Delgado Juan Córdoba Antonio Aguilera Carmen Vidal Federico García CoRIS |
| author_facet |
Susana Monge Vicente Guillot Marta Alvarez Natalia Chueca Natalia Stella Alejandro Peña Rafael Delgado Juan Córdoba Antonio Aguilera Carmen Vidal Federico García CoRIS |
| author_sort |
Susana Monge |
| title |
Clinically relevant transmitted drug resistance to first line antiretroviral drugs and implications for recommendations. |
| title_short |
Clinically relevant transmitted drug resistance to first line antiretroviral drugs and implications for recommendations. |
| title_full |
Clinically relevant transmitted drug resistance to first line antiretroviral drugs and implications for recommendations. |
| title_fullStr |
Clinically relevant transmitted drug resistance to first line antiretroviral drugs and implications for recommendations. |
| title_full_unstemmed |
Clinically relevant transmitted drug resistance to first line antiretroviral drugs and implications for recommendations. |
| title_sort |
clinically relevant transmitted drug resistance to first line antiretroviral drugs and implications for recommendations. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2014 |
| url |
https://doaj.org/article/14b946dacba94b19a7ee357758c6911c |
| work_keys_str_mv |
AT susanamonge clinicallyrelevanttransmitteddrugresistancetofirstlineantiretroviraldrugsandimplicationsforrecommendations AT vicenteguillot clinicallyrelevanttransmitteddrugresistancetofirstlineantiretroviraldrugsandimplicationsforrecommendations AT martaalvarez clinicallyrelevanttransmitteddrugresistancetofirstlineantiretroviraldrugsandimplicationsforrecommendations AT nataliachueca clinicallyrelevanttransmitteddrugresistancetofirstlineantiretroviraldrugsandimplicationsforrecommendations AT nataliastella clinicallyrelevanttransmitteddrugresistancetofirstlineantiretroviraldrugsandimplicationsforrecommendations AT alejandropena clinicallyrelevanttransmitteddrugresistancetofirstlineantiretroviraldrugsandimplicationsforrecommendations AT rafaeldelgado clinicallyrelevanttransmitteddrugresistancetofirstlineantiretroviraldrugsandimplicationsforrecommendations AT juancordoba clinicallyrelevanttransmitteddrugresistancetofirstlineantiretroviraldrugsandimplicationsforrecommendations AT antonioaguilera clinicallyrelevanttransmitteddrugresistancetofirstlineantiretroviraldrugsandimplicationsforrecommendations AT carmenvidal clinicallyrelevanttransmitteddrugresistancetofirstlineantiretroviraldrugsandimplicationsforrecommendations AT federicogarcia clinicallyrelevanttransmitteddrugresistancetofirstlineantiretroviraldrugsandimplicationsforrecommendations AT coris clinicallyrelevanttransmitteddrugresistancetofirstlineantiretroviraldrugsandimplicationsforrecommendations |
| _version_ |
1718421725286236160 |