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Surveillance and outbreak report Open Access
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Abstract

This study describes the prevalence of human immunodeficiency virus (HIV) drug resistance mutations among 1,815 patients in Denmark from 2004 to 2016 and characterises transmission clusters. POL sequences were analysed for subtype, drug resistance mutations and phylogenetic relationship. The prevalence of surveillance drug resistance mutations (SDRM) was 6.7%, while the prevalence of drug resistance mutations (DRM) with a clinical impact was 12.3%. We identified 197 transmission clusters with 706 patients. Patients 40 years or older were less likely to be members of a transmission cluster and patients in transmission clusters were less likely to be infected abroad. The proportion of late presenters (LP) was lower in active compared with inactive clusters. Large active clusters consisted of more men who have sex with men (MSM), had members more frequently infected in Denmark and contained a significantly lower proportion of LP and significantly fewer patients with DRM than small active clusters. Subtyping demonstrated that the Danish HIV epidemic is gradually becoming more composed of non-B subtypes/circulating recombinant forms. This study shows that active HIV-1 transmission has become increasingly MSM-dominated and that the recent increase in SDRM and DRM prevalence is not associated with more sustained transmission within identified transmission networks or clusters.

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/content/10.2807/1560-7917.ES.2018.23.44.1700633
2018-11-01
2024-04-18
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.44.1700633
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References

  1. Hofstra LM, Sauvageot N, Albert J, Alexiev I, Garcia F, Struck D, et al. Transmission of HIV drug resistance and the predicted effect on current first-line regimens in Europe. Clin Infect Dis. 2016;62(5):655-63.  https://doi.org/10.1093/cid/civ963  PMID: 26620652 
  2. Kassaye SG, Grossman Z, Balamane M, Johnston-White B, Liu C, Kumar P, et al. Transmitted HIV drug resistance is high and longstanding in metropolitan Washington, DC. Clin Infect Dis. 2016;63(6):836-43.  https://doi.org/10.1093/cid/ciw382  PMID: 27307507 
  3. Tostevin A, White E, Dunn D, Croxford S, Delpech V, Williams I, et al. Recent trends and patterns in HIV-1 transmitted drug resistance in the United Kingdom. HIV Med. 2017;18(3):204-13.  https://doi.org/10.1111/hiv.12414  PMID: 27476929 
  4. Audelin AM, Gerstoft J, Obel N, Mathiesen L, Laursen A, Pedersen C, et al. Molecular phylogenetics of transmitted drug resistance in newly diagnosed HIV Type 1 individuals in Denmark: a nation-wide study. AIDS Res Hum Retroviruses. 2011;27(12):1283-90.  https://doi.org/10.1089/aid.2010.0368  PMID: 21564007 
  5. Abdissa A, Yilma D, Fonager J, Audelin AM, Christensen LH, Olsen MF, et al. Drug resistance in HIV patients with virological failure or slow virological response to antiretroviral therapy in Ethiopia. BMC Infect Dis. 2014;14(1):181.  https://doi.org/10.1186/1471-2334-14-181  PMID: 24708645 
  6. de Oliveira T, Deforche K, Cassol S, Salminen M, Paraskevis D, Seebregts C, et al. An automated genotyping system for analysis of HIV-1 and other microbial sequences. Bioinformatics. 2005;21(19):3797-800.  https://doi.org/10.1093/bioinformatics/bti607  PMID: 16076886 
  7. Antinori A, Coenen T, Costagiola D, Dedes N, Ellefson M, Gatell J, et al. Late presentation of HIV infection: a consensus definition. HIV Med. 2011;12(1):61-4.  https://doi.org/10.1111/j.1468-1293.2010.00857.x  PMID: 20561080 
  8. Bennett DE, Camacho RJ, Otelea D, Kuritzkes DR, Fleury H, Kiuchi M, et al. Drug resistance mutations for surveillance of transmitted HIV-1 drug-resistance: 2009 update. PLoS One. 2009;4(3):e4724.  https://doi.org/10.1371/journal.pone.0004724  PMID: 19266092 
  9. Rhee SY, Gonzales MJ, Kantor R, Betts BJ, Ravela J, Shafer RW. Human immunodeficiency virus reverse transcriptase and protease sequence database. Nucleic Acids Res. 2003;31(1):298-303.  https://doi.org/10.1093/nar/gkg100  PMID: 12520007 
  10. Kumar S, Stecher G, Tamura K. MEGA7: Molecular Evolutionary Genetics Analysis Version 7.0 for Bigger Datasets. Mol Biol Evol. 2016;33(7):1870-4.  https://doi.org/10.1093/molbev/msw054  PMID: 27004904 
  11. Ragonnet-Cronin M, Hodcroft E, Hué S, Fearnhill E, Delpech V, Brown AJ, et al. Automated analysis of phylogenetic clusters. BMC Bioinformatics. 2013;14(1):317.  https://doi.org/10.1186/1471-2105-14-317  PMID: 24191891 
  12. Sallam M, Esbjörnsson J, Baldvinsdóttir G, Indriðason H, Björnsdóttir TB, Widell A, et al. Molecular epidemiology of HIV-1 in Iceland: Early introductions, transmission dynamics and recent outbreaks among injection drug users. Infect Genet Evol. 2017;49:157-63.  https://doi.org/10.1016/j.meegid.2017.01.004  PMID: 28082188 
  13. Karlsson A, Björkman P, Bratt G, Ekvall H, Gisslén M, Sönnerborg A, et al. Low prevalence of transmitted drug resistance in patients newly diagnosed with HIV-1 infection in Sweden 2003-2010. PLoS One. 2012;7(3):e33484.  https://doi.org/10.1371/journal.pone.0033484  PMID: 22448246 
  14. Hauser A, Hofmann A, Hanke K, Bremer V, Bartmeyer B, Kuecherer C, et al. National molecular surveillance of recently acquired HIV infections in Germany, 2013 to 2014. Euro Surveill. 2017;22(2):30436.  https://doi.org/10.2807/1560-7917.ES.2017.22.2.30436  PMID: 28105988 
  15. Gerstoft J, Kronborg G, Lundgren JD, Nielsen HI, Larsen OD, Obel N, et al. Antiretroviral behandling af HIV smittede personer. [Antiretrovial treatment of HIV-infected persons]. Odense: Danish Society of Infectious Disease; 2017. Danish. Available from: http://www.infmed.dk/download?UID=e79d8a3331640512a1f43f6910aff57da8c3ee7c
  16. Rhee SY, Blanco JL, Jordan MR, Taylor J, Lemey P, Varghese V, et al. Geographic and temporal trends in the molecular epidemiology and genetic mechanisms of transmitted HIV-1 drug resistance: an individual-patient- and sequence-level meta-analysis. PLoS Med. 2015;12(4):e1001810.  https://doi.org/10.1371/journal.pmed.1001810  PMID: 25849352 
  17. Paraskevis D, Kostaki E, Magiorkinis G, Gargalianos P, Xylomenos G, Magiorkinis E, et al. Prevalence of drug resistance among HIV-1 treatment-naive patients in Greece during 2003-2015: Transmitted drug resistance is due to onward transmissions. Infect Genet Evol. 2017;54:183-91.  https://doi.org/10.1016/j.meegid.2017.07.003  PMID: 28688977 
  18. Wertheim JO, Oster AM, Johnson JA, Switzer WM, Saduvala N, Hernandez AL, et al. Transmission fitness of drug-resistant HIV revealed in a surveillance system transmission network. Virus Evol. 2017;3(1):vex008.  https://doi.org/10.1093/ve/vex008  PMID: 28458918 
  19. Kühnert D, Kouyos R, Shirreff G, Pečerska J, Scherrer AU, Böni J, et al. Quantifying the fitness cost of HIV-1 drug resistance mutations through phylodynamics. PLoS Pathog. 2018;14(2):e1006895.  https://doi.org/10.1371/journal.ppat.1006895  PMID: 29462208 
  20. Drescher SM, von Wyl V, Yang WL, Böni J, Yerly S, Shah C, et al. Treatment-naive individuals are the major source of transmitted HIV-1 drug resistance in men who have sex with men in the Swiss HIV Cohort Study. Clin Infect Dis. 2014;58(2):285-94.  https://doi.org/10.1093/cid/cit694  PMID: 24145874 
  21. Neogi U, Siddik AB, Kalaghatgi P, Gisslén M, Bratt G, Marrone G, et al. Recent increased identification and transmission of HIV-1 unique recombinant forms in Sweden. Sci Rep. 2017;7(1):6371.  https://doi.org/10.1038/s41598-017-06860-2  PMID: 28744024 
  22. Ragonnet-Cronin M, Lycett SJ, Hodcroft EB, Hué S, Fearnhill E, Brown AE, et al. Transmission of non-B HIV subtypes in the United Kingdom is increasingly driven by large non-heterosexual transmission clusters. J Infect Dis. 2016;213(9):1410-8.  https://doi.org/10.1093/infdis/jiv758  PMID: 26704616 
  23. von Wyl V, Kouyos RD, Yerly S, Böni J, Shah C, Bürgisser P, et al. The role of migration and domestic transmission in the spread of HIV-1 non-B subtypes in Switzerland. J Infect Dis. 2011;204(7):1095-103.  https://doi.org/10.1093/infdis/jir491  PMID: 21881125 
  24. Audelin AM, Cowan SA, Obel N, Nielsen C, Jørgensen LB, Gerstoft J. Phylogenetics of the Danish HIV epidemic: the role of very late presenters in sustaining the epidemic. J Acquir Immune Defic Syndr. 2013;62(1):102-8.  https://doi.org/10.1097/QAI.0b013e318276becc  PMID: 23075917 
  25. Christiansen AH, Cowan S, Petersen A, Fonager J. HIV 2016. EPI-NEWS No 36 – 2017. Copenhagen: Staten Serums Institut; 2016. Available from: https://www.ssi.dk/English/News/EPI-NEWS/2017/No%2036%20-%202017.aspx
  26. Huaman MA, Aguilar J, Baxa D, Golembieski A, Brar I, Markowitz N. Late presentation and transmitted drug resistance mutations in new HIV-1 diagnoses in Detroit. Int J Infect Dis. 2011;15(11):e764-8.  https://doi.org/10.1016/j.ijid.2011.06.007  PMID: 21840743 
  27. Sasse A, Florence E, Pharris A, De Wit S, Lacor P, Van Beckhoven D, et al. Late presentation to HIV testing is overestimated when based on the consensus definition. HIV Med. 2016;17(3):231-4.  https://doi.org/10.1111/hiv.12292  PMID: 26222266 
  28. Puller V, Neher R, Albert J. Estimating time of HIV-1 infection from next-generation sequence diversity. PLOS Comput Biol. 2017;13(10):e1005775.  https://doi.org/10.1371/journal.pcbi.1005775  PMID: 28968389 
  29. Hassan AS, Pybus OG, Sanders EJ, Albert J, Esbjörnsson J. Defining HIV-1 transmission clusters based on sequence data. AIDS. 2017;31(9):1211-22.  https://doi.org/10.1097/QAD.0000000000001470  PMID: 28353537 
  30. van Tienen C, van de Vijver D, Noori T, Sönnerborg A, Boucher C. Letter to the editor: Pre-exposure prophylaxis for HIV in Europe: The need for resistance surveillance. Euro Surveill. 2017;22(11):30483.
  31. European Centre for Disease Prevention and Control (ECDC). ECDC roadmap for integration of molecular and genomic typing into European-level surveillance and epidemic preparedness – Version 2.1, 2016-19. Stockholm: ECDC; 2016. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/molecular-typing-EU-surveillance-epidemic-preparedness-2016-19-roadmap.pdf
  32. Keating P, Pharris A, Leitmeyer K, De Angelis S, Wensing A, Amato-Gauci AJ, et al. Assessment of HIV molecular surveillance capacity in the European Union, 2016. Euro Surveill. 2017;22(49).  https://doi.org/10.2807/1560-7917.ES.2017.22.49.17-00269  PMID: 29233253 
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