|
Basic Characteristics of Mutations
|
|
Mutation Site
|
M41L |
|
Mutation Site Sentence
|
For NRTI resistance, thymidine analogue mutations (TAMs) were most commonly observed, with T215Y/F/I/S/D/E/C/V mutations seen in 2.2% of patients (37/1658), followed by M41L in 1.2% (20/1658). M184V was seen in 0.5% (9/1658). Of the PI-associated mutations, L90M was seen in 0.8% of patients (13/1658). |
|
Mutation Level
|
Amino acid level |
|
Mutation Type
|
Nonsynonymous substitution |
|
Gene/Protein/Region
|
RT |
|
Standardized Encoding Gene
|
gag-pol:155348
|
|
Genotype/Subtype
|
HIV-1 |
|
Viral Reference
|
-
|
|
Functional Impact and Mechanisms
|
|
Disease
|
HIV Infections
|
|
Immune
|
- |
|
Target Gene
|
-
|
|
Clinical and Epidemiological Correlations
|
|
Clinical Information
|
Y |
|
Treatment
|
NRTIs |
|
Location
|
USA |
|
Literature Information
|
|
PMID
|
30151407
|
|
Title
|
Prevalence and Transmission Dynamics of HIV-1 Transmitted Drug Resistance in a Southeastern Cohort
|
|
Author
|
Levintow SN,Okeke NL,Hue S,Mkumba L,Virkud A,Napravnik S,Sebastian J,Miller WC,Eron JJ,Dennis AM
|
|
Journal
|
Open forum infectious diseases
|
|
Journal Info
|
2018 Jul 20;5(8):ofy178
|
|
Abstract
|
BACKGROUND: Transmitted drug resistance (TDR) compromises clinical management and outcomes. Transmitted drug resistance surveillance and identification of growing transmission clusters are needed in the Southeast, the epicenter of the US HIV epidemic. Our study investigated prevalence and transmission dynamics in North Carolina. METHODS: We analyzed surveillance drug resistance mutations (SDRMs) using partial pol sequences from patients presenting to 2 large HIV outpatient clinics from 1997 to 2014. Transmitted drug resistance prevalence was defined as >/=1 SDRMs among antiretroviral therapy (ART)-naive patients. Binomial regression was used to characterize prevalence by calendar year, drug class, and demographic and clinical factors. We assessed the transmission networks of patients with TDR with maximum likelihood trees and Bayesian methods including background pol sequences (n = 15 246). RESULTS: Among 1658 patients with pretherapy resistance testing, >/=1 SDRMs was identified in 199 patients, with an aggregate TDR prevalence of 12% (95% confidence interval, 10% to 14%) increasing over time (P = .02). Resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs; 8%) was common, followed by nucleoside reverse transcriptase inhibitors (4%) and protease inhibitors (2%). Factors associated with TDR were being a man reporting sex with men, white race, young age, higher CD4 cell count, and being a member of a transmission cluster. Transmitted drug resistance was identified in 106 clusters ranging from 2 to 26 members. Cluster resistance was primarily NNRTI and dominated by ART-naive patients or those with unknown ART initiation. CONCLUSIONS: Moderate TDR prevalence persists in North Carolina, predominantly driven by NNRTI resistance. Most TDR cases were identified in transmission clusters, signifying multiple local transmission networks and TDR circulation among ART-naive persons. Transmitted drug resistance surveillance can detect transmission networks and identify patients for enhanced services to promote early treatment.
|
|
Sequence Data
|
-
|
|
|