@article {10854,
	title = {Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe.},
	journal = {Clin Infect Dis},
	volume = {62},
	year = {2016},
	month = {2016 Mar 01},
	pages = {655-663},
	abstract = {BACKGROUND: Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001.

METHODS: Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)-infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0.

RESULTS: The overall prevalence of TDR did not change significantly over time and was 8.3\% (95\% confidence interval, 7.2\%-9.5\%) in 2008-2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5\%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9\%) and protease inhibitor mutations (2.0\%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5\% and 6.5\% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones.

CONCLUSIONS: Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected.},
	keywords = {Adult, Anti-HIV Agents, Drug Resistance, Viral, Europe, Female, HIV Infections, HIV Protease Inhibitors, HIV-1, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Mutation, Prevalence, Reverse Transcriptase Inhibitors},
	issn = {1537-6591},
	doi = {10.1093/cid/civ963},
	author = {Hofstra, L Marije and Sauvageot, Nicolas and Albert, Jan and Alexiev, Ivailo and Garcia, Federico and Struck, Daniel and Van de Vijver, David A M C and {\r A}sj{\"o}, Birgitta and Beshkov, Danail and Coughlan, Suzie and Descamps, Diane and Griskevicius, Algirdas and Hamouda, Osamah and Horban, Andrzej and Van Kasteren, Marjo and Kolupajeva, Tatjana and Kostrikis, Leondios G and Liitsola, Kirsi and Linka, Marek and Mor, Orna and Nielsen, Claus and Otelea, Dan and Paraskevis, Dimitrios and Paredes, Roger and Poljak, Mario and Puchhammer-St{\"o}ckl, Elisabeth and S{\"o}nnerborg, Anders and Stanekov{\'a}, Danica and Stanojevic, Maja and Van Laethem, Kristel and Zazzi, Maurizio and Zidovec Lepej, Snjezana and Boucher, Charles A B and Schmit, Jean-Claude and Wensing, Annemarie M J and Puchhammer-Stockl, E and Sarcletti, M and Schmied, B and Geit, M and Balluch, G and Vandamme, A-M and Vercauteren, J and Derdelinckx, I and Sasse, A and Bogaert, M and Ceunen, H and De Roo, A and De Wit, S and Echahidi, F and Fransen, K and Goffard, J-C and Goubau, P and Goudeseune, E and Yombi, J-C and Lacor, P and Liesnard, C and Moutschen, M and Pierard, D and Rens, R and Schrooten, Y and Vaira, D and Vandekerckhove, L P R and Van den Heuvel, A and Van Der Gucht, B and Van Ranst, M and Van Wijngaerden, E and Vandercam, B and Vekemans, M and Verhofstede, C and Clumeck, N and Van Laethem, K and Beshkov, D and Alexiev, I and Lepej, S Zidovec and Begovac, J and Kostrikis, L and Demetriades, I and Kousiappa, I and Demetriou, V and Hezka, J and Linka, M and Maly, M and Machala, L and Nielsen, C and J{\o}rgensen, L B and Gerstoft, J and Mathiesen, L and Pedersen, C and Nielsen, H and Laursen, A and Kvinesdal, B and Liitsola, K and Ristola, M and Suni, J and Sutinen, J and Descamps, D and Assoumou, L and Castor, G and Grude, M and Flandre, P and Storto, A and Hamouda, O and K{\"u}cherer, C and Berg, T and Braun, P and Poggensee, G and D{\"a}umer, M and Eberle, J and Heiken, H and Kaiser, R and Knechten, H and Korn, K and M{\"u}ller, H and Neifer, S and Schmidt, B and Walter, H and Gunsenheimer-Bartmeyer, B and Harrer, T and Paraskevis, D and Hatzakis, A and Zavitsanou, A and Vassilakis, A and Lazanas, M and Chini, M and Lioni, A and Sakka, V and Kourkounti, S and Paparizos, V and Antoniadou, A and Papadopoulos, A. and Poulakou, G and Katsarolis, I and Protopapas, K and Chryssos, G and Drimis, S and Gargalianos, P and Xylomenos, G and Lourida, G and Psichogiou, M and Daikos, G L and Sipsas, N V and Kontos, A and Gamaletsou, M N and Koratzanis, G and Sambatakou, H and Mariolis, H and Skoutelis, A and Papastamopoulos, V and Georgiou, O and Panagopoulos, P and Maltezos, E and Coughlan, S and De Gascun, C and Byrne, C and Duffy, M and Bergin, C and Reidy, D and Farrell, G and Lambert, J and O{\textquoteright}Connor, E and Rochford, A and Low, J and Coakely, P and O{\textquoteright}Dea, S and Hall, W and Mor, O and Levi, I and Chemtob, D and Grossman, Z and Zazzi, M and de Luca, A and Balotta, C and Riva, C and Mussini, C and Caramma, I and Capetti, A and Colombo, M C and Rossi, C and Prati, F and Tramuto, F and Vitale, F and Ciccozzi, M and Angarano, G and Rezza, G and Kolupajeva, T and Vasins, O and Griskevicius, A and Lipnickiene, V and Schmit, J C and Struck, D and Sauvageot, N and Hemmer, R and Arendt, V and Michaux, C and Staub, T and Sequin-Devaux, C and Wensing, A M J and Boucher, C A B and van de Vijver, D A M C and van Kessel, A and van Bentum, P H M and Brinkman, K and Connell, B J and van der Ende, M E and Hoepelman, I M and van Kasteren, M and Kuipers, M and Langebeek, N and Richter, C and Santegoets, R M W J and Schrijnders-Gudde, L and Schuurman, R and van de Ven, B J M and {\r A}sj{\"o}, B and Kran, A-M Bakken and Ormaasen, V and Aavitsland, P and Horban, A and Stanczak, J J and Stanczak, G P and Firlag-Burkacka, E and Wiercinska-Drapalo, A and Jablonowska, E and Maolepsza, E and Leszczyszyn-Pynka, M and Szata, W and Camacho, R and Palma, C and Borges, F and Paix{\~a}o, T and Duque, V and Ara{\'u}jo, F and Otelea, D and Paraschiv, S and Tudor, A M and Cernat, R and Chiriac, C and Dumitrescu, F and Prisecariu, L J and Stanojevic, M and Jevtovic, Dj and Salemovic, D and Stanekova, D and Habekova, M and Chabadov{\'a}, Z and Drobkova, T and Bukovinova, P and Shunnar, A and Truska, P and Poljak, M and Lunar, M and Babic, D and Tomazic, J and Vidmar, L and Vovko, T and Karner, P and Garcia, F and Paredes, R and Monge, S and Moreno, S and Del Amo, J and Asensi, V and Sirvent, J L and de Mendoza, C and Delgado, R and Guti{\'e}rrez, F and Berenguer, J and Garcia-Bujalance, S and Stella, N and de Los Santos, I and Blanco, J R and Dalmau, D and Rivero, M and Segura, F and El{\'\i}as, M J P{\'e}rez and Alvarez, M and Chueca, N and Rodr{\'\i}guez-Mart{\'\i}n, C and Vidal, C and Palomares, J C and Viciana, I and Viciana, P and Cordoba, J and Aguilera, A and Domingo, P and Galindo, M J and Miralles, C and Del Pozo, M A and Ribera, E and Iribarren, J A and Ruiz, L and de la Torre, J and Vidal, F and Clotet, B and Albert, J and Heidarian, A and Aperia-Peipke, K and Axelsson, M and Mild, M and Karlsson, A and S{\"o}nnerborg, A and Thalme, A and Nav{\'e}r, L and Bratt, G and Karlsson, A and Blaxhult, A and Gissl{\'e}n, M and Svennerholm, B and Bergbrant, I and Bj{\"o}rkman, P and S{\"a}ll, C and Mellgren, {\r A} and Lindholm, A and Kuylenstierna, N and Montelius, R and Azimi, F and Johansson, B and Carlsson, M and Johansson, E and Ljungberg, B and Ekvall, H and Strand, A and M{\"a}kitalo, S and {\"O}berg, S and Holmblad, P and H{\"o}fer, M and Holmberg, H and Josefson, P and Ryding, U}
}
