@article{3110528,
    title = "Increase in transmitted resistance to non-nucleoside reverse transcriptase inhibitors among newly diagnosed HIV-1 infections in Europe",
    author = "Frentz, D. and Van de Vijver, D.A.M.C. and Abecasis, A.B. and Albert, J. and Hamouda, O. and Jørgensen, L.B. and Kücherer, C. and Struck, D. and Schmit, J.-C. and Vercauteren, J. and Åsjö, B. and Balotta, C. and Beshkov, D. and Camacho, R.J. and Clotet, B. and Coughlan, S. and Griskevicius, A. and Grossman, Z. and Horban, A. and Kolupajeva, T. and Korn, K. and Kostrikis, L.G. and Liitsola, K. and Linka, M. and Nielsen, C. and Otelea, D. and Paraskevis, D. and Paredes, R. and Poljak, M. and Puchhammer-Stöckl, E. and Sönnerborg, A. and Stanekova, D. and Stanojevic, M. and Van Wijngaerden, E. and Wensing, A.M.J. and Boucher, C.A.B. 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 Vandercam, B. and Vekemans, M. and Verhofstede, C. and Clumeck, N. and Van Laethem, K. and Demetriades, I. and Kousiappa, I. and Demetriou, V. and Hezka, J. and Bruckova, M. and Linka, M. and Machala, L. and Nielsen, C. and Jørgensen, L.B. and Gerstoft, J. and Mathiesen, L. and Pedersen, C. and Nielsen, H. and Laursen, A. and Kvinesdal, B. and Salminen, M. and Ristola, M. and Liitsola, K. and Suni, J. and Sutinen, J. and Korn, K. and Kücherer, C. and Berg, T. and Braun, P. and Poggensee, G. and Däumer, M. and Eberle, J. and Heiken, H. and Kaiser, R. and Knechten, H. and Müller, H. and Neifer, S. and Schmidt, B. and Walter, H. and Gunsenheimer-Bartmeyer, B. and Harrer, T. and Paraskevis, D. and Hatzakis, A. and Magiorkinis, E. and Hatzitheodorou, E. and Haida, C. and Zavitsanou, A. and Magiorkinis, G. and Lazanas, M. and Chini, M. and Magafas, N. and Tsogas, N. and Paparizos, V. and Kourkounti, S. and Antoniadou, A. and Papadopoulos, A. and Panagopoulos, P. and Poulakou, G. and Sakka, V. and Chryssos, G. and Drimis, S. and Gargalianos, P. and Lelekis, M. and Chilomenos, G. and Psichogiou, M. and Daikos, G.L. and Panos, G. and Haratsis, G. and Kordossis, T. and Kontos, A. and Koratzanis, G. and Theodoridou, M. and Mostrou, G. and Spoulou, V. 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'Connor, E. and Rochford, A. and Low, J. and Coakely, P. and O'Dea, S. and Hall, W. and Grossman, Z. and Levi, I. and Chemtob, D. 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 Schmit, J.C. and Struck, D. and Hemmer, R. and Arendt, V. and Staub, T. and Schneider, F. and Roman, F. and Wensing, A.M.J. and Boucher, C.A.B. and van Kessel, A. and van Bentum, P.H.M. and Brinkman, K. and op de Coul, E.L. and van der Ende, M.E. and Hoepelman, I. and van Kasteren, M. and Juttmann, J. and Kuipers, M. and Langebeek, N. and Richter, C. and Santegoets, R. and Schrijnders-Gudde, L. and Schuurman, R. and van de Ven, B.J.M. and Åsjö, B. 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 Malolepsza, E. and Leszczyszyn-Pynka, M. and Szata, W. and Camacho, R. and Palma, C. and Borges, F. and Paixão, T. and Duque, V. and Araújo, F. and Jevtovic, D. and Salemovic, D. and Stanekova, D. and Habekova, M. and Mokras, M. 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 Clotet, B. 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 Garcia, F. and Paredes, R. and Albert, J. and Heidarian, A. and Aperia-Peipke, K. and Axelsson, M. and Mild, M. and Karlsson, A. and Sönnerborg, A. and Thalme, A. and Navér, L. and Bratt, G. and Karlsson, A. and Blaxhult, A. and Gisslén, M. and Svennerholm, B. and Bergbrant, I. and Björkman, P. and Säll, C. and Mellgren, Å. 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 Mäkitalo, S. and öberg, S. and Holmblad, P. and Höfer, M. and Holmberg, H. and Josefson, P. and Ryding, U. and on behalf of the SPREAD Programme",
    journal = "BMC Infectious Diseases",
    year = "2014",
    volume = "14",
    number = "1",
    publisher = "BioMed Central Ltd.",
    issn = "1471-2334",
    doi = "10.1186/1471-2334-14-407",
    keywords = "nonnucleoside reverse transcriptase inhibitor;  proteinase inhibitor, adult;  Article;  controlled study;  Europe;  female;  human;  Human immunodeficiency virus 1 infection;  major clinical study;  male;  molecular phylogeny;  nonhuman;  nucleotide sequence;  risk factor;  unindexed sequence;  virus mutation;  virus resistance;  virus strain;  virus transmission, Adult;  Anti-HIV Agents;  Drug Resistance, Viral;  Europe;  Female;  Genotype;  HIV Infections;  HIV-1;  Humans;  Male;  Mutation;  Phylogeny;  Prevalence",
    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. © 2014 Frentz et al.; licensee BioMed Central Ltd."
}