@article {10873,
	title = {Increase in transmitted resistance to non-nucleoside reverse transcriptase inhibitors among newly diagnosed HIV-1 infections in Europe.},
	journal = {BMC Infect Dis},
	volume = {14},
	year = {2014},
	month = {2014 Jul 21},
	pages = {407},
	abstract = {BACKGROUND: One out of ten newly diagnosed patients in Europe was infected with a virus carrying a drug resistant mutation. We analysed the patterns over time for transmitted drug resistance mutations (TDRM) using data from the European Spread program.

METHODS: Clinical, epidemiological and virological data from 4317 patients newly diagnosed with HIV-1 infection between 2002 and 2007 were analysed. Patients were enrolled using a pre-defined sampling strategy.

RESULTS: The overall prevalence of TDRM in this period was 8.9\% (95\% CI: 8.1-9.8). Interestingly, significant changes over time in TDRM caused by the different drug classes were found. Whereas nucleoside resistance mutations remained constant at 5\%, a significant decline in protease inhibitors resistance mutations was observed, from 3.9\% in 2002 to 1.6\% in 2007 (p = 0.001). In contrast, resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) doubled from 2.0\% in 2002 to 4.1\% in 2007 (p = 0.004) with 58\% of viral strains carrying a K103N mutation. Phylogenetic analysis showed that these temporal changes could not be explained by large clusters of TDRM.

CONCLUSION: During the years 2002 to 2007 transmitted resistance to NNRTI has doubled to 4\% in Europe. The frequent use of NNRTI in first-line regimens and the clinical impact of NNRTI mutations warrants continued monitoring.},
	keywords = {Adult, Anti-HIV Agents, Drug Resistance, Viral, Europe, Female, Genotype, HIV Infections, HIV-1, Humans, Male, Mutation, Phylogeny, Prevalence},
	issn = {1471-2334},
	doi = {10.1186/1471-2334-14-407},
	author = {Frentz, Dineke and Van de Vijver, David A M C and Abecasis, Ana B and Albert, Jan and Hamouda, Osamah and J{\o}rgensen, Louise B and K{\"u}cherer, Claudia and Struck, Daniel and Schmit, Jean-Claude and Vercauteren, Jurgen and {\r A}sj{\"o}, Birgitta and Balotta, Claudia and Beshkov, Danail and Camacho, Ricardo J and Clotet, Bonaventura and Coughlan, Suzie and Griskevicius, Algirdas and Grossman, Zehava and Horban, Andrzej and Kolupajeva, Tatjana and Korn, Klaus and Kostrikis, Leondios G and Liitsola, Kirsi and Linka, Marek 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 Stanekova, Danica and Stanojevic, Maja and Van Wijngaerden, Eric and Wensing, Annemarie M J and Boucher, Charles A B}
}
