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Estimating prevalence of accumulated HIV-1 drug resistance in a cohort of patients on antiretroviral therapy

2011; Oxford University Press; Volume: 66; Issue: 4 Linguagem: Inglês

10.1093/jac/dkr006

1460-2091

WP Bannister, Alessandro Cozzi‐Lepri, Jesper Kjær, B Clotet, Adriano Lazzarin, J.-P. Viard, Gitte Kronborg, Dan Duiculescu, Marek Beniowski, Ladislav Machala, Andrew Phillips, M Losso, Christelle Elias, N. Vetter, Robert Zangerle, Igor Karpov, Anna Vassilenko, В. М. Мицура, O. Suetnov, Nathan Clumeck, S. De Wit, M Delforge, Robert Colebunders, Linos Vandekerckhove, Vesna Hadžiosmanović, Kosta Kostov, Josip Begovać, Ladislav Machala, H Rozsypal, Dalibor Sedláček, Jens Nielsen, Gitte Kronborg, Thomas Benfield, MV Larsen, J Gerstoft, Terese L. Katzenstein, BR Hansen, Peter Skinhøj, C. Pedersen, Lars Oestergaard, Kai Zilmer, Jelena Šmidt, Matti Ristola, Christine Katlama, Jean‐Paul Viard, Pierre Marie Girard, J. M. Livrozet, Philippe Vanhems, Christian Pradier, François Dabis, D. Neau, Jürgen K. Rockstroh, Robert L. Schmidt, Jan van Lunzen, Olaf Degen, HJ Stellbrink, S Staszewski, John W. Goethe, J. R. Bogner, G Fätkenheuer, J. Kosmidis, Panagiotis Gargalianos, G. Xylomenos, J. Perdios, George Panos, A. Filandras, E. Karabatsaki, Dénes Bánhegyi, F Mulcahy, Israel Yust, Dianna Turner, Michael Burke, S Pollack, Gamal Hassoun, Shlomo Maayan, Antonio Chiesi, Roberto Esposito, I. Mazeu, Cristina Mussini, Claudio Arici, R. Pristerà, Francesco Mazzotta, Andrea Gabbuti, Vincenzo Vullo, Miriam Lichtner, Antonio Chirianni, E. Montesarchio, Miriam Gargiulo, G. Antonucci, Fabio Iacomi, Pasquale Narciso, Chrysoula Vlassi, Maria Carla Re, Adriano Lazzarin, Renato Finazzi, Massimo Galli, Anna Lisa Ridolfo, Antonella d’Arminio Monforte, Baiba Rozentāle, Indra Zeltiņa, Saulius Chaplinskas, R Hemmer, Thérèse Staub, Peter Reiss, JN Bruun, A Mæland, Vidar Ormaasen, Brygida Knysz, Jacek Gąsiorowski, Andrzéj Horban, Elżbieta Bąkowska, Anna Grzeszczuk, Robert Flisiak, Anna Boroń‐Kaczmarska, M. Pynka, Marek Beniowski, E. Mularska, H Trocha, Elżbieta Jabłonowska, Ewa Małolepsza, Kamila Wójcik, Francisco Antunes, Emília Valadas, Kamal Mansinho, Fernando Maltêz, Dan Duiculescu, Aza Rakhmanova, Elena Vinogradova, Djordje Jevtović, M Mokrás, D Staneková, Janez Tomažič, Juan González‐Lahoz, Vincent Soriano, Pablo Labarga, J. Medraño, Santiago Moreno, Bonaventura Clotet, Antoni Jou, Roger Paredes, C. Tural, Javier Juega Puig, Isabel Bravo, José M. Gatell, Joaquim Miró, Peré Domingo, María Luisa Navarro Gómez, Gràcia Mateo, M. A. Sambeat, Anna Karlsson, Bruno Ledergerber, Rainer Weber, Bernard Hirschel, E. Boffi, Hansjakob Furrer, Manuel Battegay, Luigia Elzi, Елена Николаевна Кравченко, Nelly Chentsova, S. Servitskiy, Sergii Antoniak, Максим Ігорович Краснов, Simon Barton, Margaret Johnson, D Mercey, Andrew Phillips, Margaret Johnson, Amanda Mocroft, M. Murphy, Jonathan Weber, G Scullard, Martin Fisher, Clifford Leen, Bonaventura Clotet, Roger Paredes, Francisco Antunes, Bonaventura Clotet, Dan Duiculescu, José M. Gatell, Brian Gazzard, Andrzéj Horban, Anna Karlsson, Christine Katlama, Bruno Ledergerber, Antonella D’Arminio Montforte, Andrew Phillips, Aza Rakhmanova, Peter Reiss, Jürgen K. Rockstroh, Jens Lundgren, O. Kirk, Amanda Mocroft, Nina Friis‐Møller, Alessandro Cozzi‐Lepri, Wendy Bannister, Mark Ellefson, Annie Borch, Daria Podlekareva, Jesper Kjær, Lars Peters, J. Reekie, Justyna D. Kowalska,

HIV/AIDS Research and Interventions

Estimating the prevalence of accumulated HIV drug resistance in patients receiving antiretroviral therapy (ART) is difficult due to lack of resistance testing at all occasions of virological failure and in patients with undetectable viral load. A method to estimate this for 6498 EuroSIDA patients who were under follow-up on ART at 1 July 2008 was therefore developed by imputing data on patients with no prior resistance test results, based on the probability of detecting resistance in tested patients with similar profiles.Using all resistance test results available, predicted intermediate/high-level resistance to specific drug classes [nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs)] was derived using the Stanford algorithm v5.1.2. Logistic regression models were then employed to estimate predicted probability of resistance to each drug class for given values of current viral load, history of virological failure and previous virological suppression. Based on these predicted probabilities and patients' covariate profiles, estimates of prevalence in 5355 patients with no prior test results were obtained. Overall prevalence of resistance was estimated by pooling these data with those observed in the remaining 1143 tested patients.Prevalence of NRTI, NNRTI and PI resistance was estimated as 43% (95% confidence interval: 39%-46%), 15% (13%-18%) and 25% (22%-28%), respectively.This method provides estimates for the proportion of treated patients in a cohort who harbour resistance on a given date, which are less likely to be affected by selection bias due to missing resistance data and will allow us to estimate prevalence of resistance to different drug classes at specific timepoints in HIV-infected populations on ART.