Emergence of Acquired HIV-1 Drug Resistance Almost Stopped in Switzerland: A 15-Year Prospective Cohort Analysis

Background. Drug resistance is a major barrier to successful antiretroviral treatment (ART). Therefore, it is important to monitor time trends at a population level. Methods. We included 11 084 ART-experienced patients from the Swiss HIV Cohort Study (SHCS) between 1999 and 2013. The SHCS is highly...

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Bibliographic Details
Published in:Clinical infectious diseases 2016-05, Vol.62 (10), p.1310-1317
Main Authors: Scherrer, Alexandra U., von Wyl, Viktor, Yang, Wan-Lin, Kouyos, Roger D., Böni, Jürg, Yerly, Sabine, Klimkait, Thomas, Aubert, Vincent, Cavassini, Matthias, Battegay, Manuel, Furrer, Hansjakob, Calmy, Alexandra, Vernazza, Pietro, Bernasconi, Enos, Günthard, Huldrych F.
Format: Article
Language:English
Subjects:
Adult
Algorithms
Anti-HIV Agents - pharmacology
Anti-HIV Agents - therapeutic use
Antiretroviral drugs
Drug resistance
Drug Resistance, Viral - genetics
Drug therapy
Female
Genotype & phenotype
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV Infections - virology
HIV-1 - drug effects
HIV-1 - genetics
HIV/AIDS
Human immunodeficiency virus 1
Humans
Male
Middle Aged
Mutation
Pharmacology
Prevalence
Prospective Studies
Switzerland - epidemiology
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Summary:Background. Drug resistance is a major barrier to successful antiretroviral treatment (ART). Therefore, it is important to monitor time trends at a population level. Methods. We included 11 084 ART-experienced patients from the Swiss HIV Cohort Study (SHCS) between 1999 and 2013. The SHCS is highly representative and includes 72% of patients receiving ART in Switzerland. Drug resistance was defined as the presence of ≥1 major mutation in a genotypic resistance test. To estimate the prevalence of drug resistance, data for patients with no resistance test was imputed based on the patient's risk of harboring drug-resistant viruses. Results. The emergence of new drug resistance mutations declined dramatically from 401 to 23 patients between 1999 and 2013. The upper estimated prevalence limit of drug resistance among ART-experienced patients decreased from 57.0% in 1999 to 37.1% in 2013. The prevalence of 3-class resistance decreased from 9.0% to 4.4% and was always
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciw128