@article {10874,
	title = {Patterns of transmitted HIV drug resistance in Europe vary by risk group.},
	journal = {PLoS One},
	volume = {9},
	year = {2014},
	month = {2014},
	pages = {e94495},
	abstract = {BACKGROUND: In Europe, a continuous programme (SPREAD) has been in place for ten years to study transmission of drug resistant HIV. We analysed time trends of transmitted drug resistance mutations (TDRM) in relation to the risk behaviour reported.

METHODS: HIV-1 patients newly diagnosed in 27 countries from 2002 through 2007 were included. Inclusion was representative for risk group and geographical distribution in the participating countries in Europe. Trends over time were calculated by logistic regression.

RESULTS: From the 4317 patients included, the majority was men-having-sex-with-men -MSM (2084, 48\%), followed by heterosexuals (1501, 35\%) and injection drug users (IDU) (355, 8\%). MSM were more often from Western Europe origin, infected with subtype B virus, and recently infected (<1 year) (p<0.001). The prevalence of TDRM was highest in MSM (prevalence of 11.1\%), followed by heterosexuals (6.6\%) and IDU (5.1\%, p<0.001). TDRM was predominantly ascribed to nucleoside reverse transcriptase inhibitors (NRTI) with a prevalence of 6.6\% in MSM, 3.3\% in heterosexuals and 2.0\% in IDU (p = 0.001). A significant increase in resistance to non- nucleoside reverse transcriptase inhibitors (NNRTIs) and a decrease in resistance to protease inhibitors was observed in MSM (p = 0.008 and p = 0.006, respectively), but not in heterosexual patients (p = 0.68 and p = 0.14, respectively).

CONCLUSIONS: MSM showed to have significantly higher TDRM prevalence compared to heterosexuals and IDU. The increasing NNRTI resistance in MSM is likely to negatively influence the therapy response of first-line therapy, as most include NNRTI drugs.},
	keywords = {Adult, Anti-HIV Agents, Drug Resistance, Viral, Europe, Female, Heterosexuality, HIV Infections, HIV-1, Homosexuality, Male, Humans, Logistic Models, Male, Middle Aged, Protease Inhibitors, Reverse Transcriptase Inhibitors, Risk, Risk-Taking, Sexual Behavior, Substance Abuse, Intravenous},
	issn = {1932-6203},
	doi = {10.1371/journal.pone.0094495},
	author = {Frentz, Dineke and van de Vijver, David and Abecasis, Ana and Albert, Jan and Hamouda, Osamah and J{\o}rgensen, Louise and K{\"u}cherer, Claudia and Struck, Daniel and Schmit, Jean-Claude and Vercauteren, Jurgen and Asj{\"o}, Birgitta and Balotta, Claudia and Bergin, Colm and Beshkov, Danail and Camacho, Ricardo and Clotet, Bonaventura and Griskevicius, Algirdas and Grossman, Zehava and Horban, Andrzej and Kolupajeva, Tatjana and Korn, Klaus and Kostrikis, Leondios and Linka, Kirsi Liitsola 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 Vandamme, Anne-Mieke and Boucher, Charles and Wensing, Annemarie}
}
