抗药性
整合酶
逆转录酶
病毒学
医学微生物学
抗性突变
整合酶抑制剂
医学
传输(电信)
人类免疫缺陷病毒(HIV)
生物
内科学
抗逆转录病毒疗法
病毒载量
聚合酶链反应
遗传学
基因
电气工程
工程类
作者
Uwe Fiebig,Britta Altmann,Andrea Hauser,Uwe Koppe,Kirsten Hanke,Barbara Gunsenheimer‐Bartmeyer,Viviane Bremer,Axel Baumgarten,Norbert Bannert
标识
DOI:10.1186/s12879-023-08649-3
摘要
Abstract Background The transmission of resistant HIV variants jeopardizes the effective use of antiretrovirals for therapy and prophylaxis. Molecular surveillance of new HIV diagnoses with a focus on prevalence and type of resistance associated mutations and the subtype of circulating viruses is mandatory. Method From 2017 to 2020, 11,527 new HIV diagnoses were reported in Germany to the Robert Koch Institute (RKI). Protease (PR) and reverse-transcriptase (RT) sequences were obtained from 4559 (39.6%) cases, and PR, RT and integrase (IN) sequences were obtained from 3097 (26.9%) cases. The sequences were analyzed with data from the national HIV reports. Results Among all cases in the analysis, the proportion of primary resistance was 4.3% for nucleoside reverse-transcriptase inhibitors (NRTIs), 9.2% for non-NRTI (NNRTIs), 3.3% for protease inhibitors (PIs) and 1.4% for integrase inhibitors (INIs). Dual-class resistance was highest for NRTIs/NNRTIs with 1.2%. There was no trend in the proportion of viruses resistant to drug classes. Most individual key mutations associated with relevant resistance had a prevalence below 1% including K65R (0.1%) and M184V (0.6%). A notable exception was K103NS, with a prevalence of 2.9% and a significant increase (p Trend =0.024) during 2017–2020. In this period, diagnoses of infections with HIV-1 subtype B were the most common at 58.7%, but its prevalence was declining (p Trend =0.049) while the frequency of minority subtypes (each < 1%) increased (p Trend =0.007). Subtype B was highest (75.6%) in men who have sex with men (MSM) and lowest in reported heterosexual transmissions (HETs, 22.6%). Conclusion The percentage of primary resistance was high but at a stable level. A genotypic determination of resistance is therefore still required before the start of therapy. The subtype diversity of circulating HIV-1 is increasing.
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