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2018-11-08Zeitschriftenartikel DOI: 10.25646/5999
Increasing proportions of HIV-1 non-B subtypes and of NNRTI resistance between 2013 and 2016 in Germany: Results from the national molecular surveillance of new HIV-diagnoses
dc.contributor.authorHauser, Andrea
dc.contributor.authorHofmann, Alexandra
dc.contributor.authorMeixenberger, Karolin
dc.contributor.authorAltmann, Britta
dc.contributor.authorHanke, Kirsten
dc.contributor.authorBremer, Viviane
dc.contributor.authorBartmeyer, Barbara
dc.contributor.authorBannert, Norbert
dc.date.accessioned2019-03-27T08:11:12Z
dc.date.available2019-03-27T08:11:12Z
dc.date.issued2018-11-08none
dc.identifier.other10.1371/journal.pone.0206234
dc.identifier.urihttp://edoc.rki.de/176904/6034
dc.description.abstractBackground Molecular surveillance of newly diagnosed HIV-infections is important for tracking trends in circulating HIV-variants, including those with transmitted drug resistances (TDR) to sustain ART efficacy. Methods Dried serum spots (DSS) are received together with the statutory notification of a new diagnosis. 'Recent infections' (<155 days) classified by a 'recent infection test algorithm' (BED-CEIA and clinical data) are genotyped in HIV-protease (PR), reverse transcriptase (RT) and integrase (INT) to determine the HIV-1 subtype, to calculate prevalence and trends of TDR, to predict baseline susceptibility and to identify potential transmission clusters for resistant variants. Results Between January 2013 and December 2016, 1,885 recent infections were analysed regarding the PR/RT genomic region, with 43.5% of these also being subjected to the analysis of INT. The proportion of HIV-1 non-B viruses (31.3%; 591/1,885) increased from 21.6% to 36.0%, particularly the subtypes A (5.0% to 8.3%) and C (3.2% to 7.7%; all ptrends < 0.01). The subtype A increment is mainly due to transmissions within men who have sex with men (MSM) while subtype C transmissions are associated with heterosexuals and people who inject drugs. The prevalence of TDR was stable at 11.0% (208/1,885) over the study period. Resistances to nucleotide RT inhibitors (NRTI) and PR inhibitors (PI) were 4.5% and 3.2%, respectively, without identifiable trends. In contrast, resistances to non-NRTIs (NNRTI, 4.7%) doubled between 2014 and 2016 from 3.2% to 6.4% (ptrend = 0.02) mainly due to the K103N mutation (from 1.7% to 4.1%; ptrend = 0.03) predominantly detected in recently infected German MSM not linked to transmission clusters. Transmitted INSTI mutations were present in only one case (T66I) and resistance to dolutegravir was not identified at all. Reduced susceptibility to recommended first-line therapies was low with 1.0% for PIs, 1.3% for NRTIs and 0.7% for INSTIs, but high for the NNRTIs efavirence (4.9%) and rilpivirine (6.0%) due to the K103N mutation and the polymorphic mutation E138A. These trends in therapy-naïve individuals impact current first-line regimens and require awareness and vigilant surveillance.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subjectmen-who-have-sex-with-meneng
dc.subjectHIV-1eng
dc.subjectAntimicrobial resistanceeng
dc.subjectGermanyeng
dc.subjectMutation databaseseng
dc.subjectGerman peopleeng
dc.subjectEuropeeng
dc.subjectSequence databaseseng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleIncreasing proportions of HIV-1 non-B subtypes and of NNRTI resistance between 2013 and 2016 in Germany: Results from the national molecular surveillance of new HIV-diagnosesnone
dc.typearticle
dc.identifier.urnurn:nbn:de:kobv:0257-176904/6034-0
dc.identifier.doihttp://dx.doi.org/10.25646/5999
dc.type.versionpublishedVersionnone
local.edoc.container-titlePLoS ONEnone
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0206234none
local.edoc.container-publisher-namePublic Library of Sciencenone
local.edoc.container-volume13none
local.edoc.container-issue11none
local.edoc.container-reportyear2018none
local.edoc.container-year2018none
local.edoc.container-firstpage1none
local.edoc.container-lastpage18none
local.edoc.rki-departmentInfektionskrankheitennone
dc.description.versionPeer Reviewednone

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