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The demise of multidrug-resistant HIV-1: the national time trend in Portugal

2012; Oxford University Press; Volume: 68; Issue: 4 Linguagem: Inglês

10.1093/jac/dks470

1460-2091

Jurgen Vercauteren, Kristof Theys, A.P. Carvalho, Emília Valadas, L. Duque, Eugénio Teófilo, T. Faria, D. Faria, Jaime H. Vera, Maria João Águas, Silvia Perés Wingeyer, Kamal Mansinho, Anne‐Mieke Vandamme, Ricardo Camacho, Kamal Mansinho, Ana Cláudia Miranda, Isabel Aldir, François Ventura, Jaime Nina, Fernando S. Borges, Emília Valadas, Manuela Doroana, Francisco Antunes, Maria João Aleixo, Maria João Águas, J. Botas, Teresa Branco, Jaime H. Vera, Inês Vaz Pinto, José Poças, Joaquim Sá, L. Duque, A. Diniz, Ana Mineiro, Filipa Gomes, Cláudia N. Santos, D. Faria, Paulo Fonseca, Paula Proença, Lucas Tavares, Cláudio Guerreiro, J. Narciso, T. Faria, Eugénio Teófilo, S. Pinheiro, Isabel Germano, Umbelina Caixas, Nuno R. Faria, Ana Reis, M. Bentes Jesus, G. Amaro, Fausto Roxo, Raquel de Sousa Abreu, Isabel Neves,

HIV Research and Treatment

Despite a decreasing mortality and morbidity in treated HIV-1 patients, highly active antiretroviral treatment (HAART) can still fail due to the development of drug resistance. Especially, multidrug-resistant viruses pose a threat to efficient therapy. We studied the changing prevalence of multidrug resistance (MDR) over time in a cohort of HIV-1-infected patients in Portugal. We used data of 8065 HIV-1-infected patients followed from July 2001 up to April 2012 in 22 hospitals located in Portugal. MDR at a specific date of sampling was defined as no more than one fully active drug (excluding integrase and entry inhibitors) at that time authorized by the Portuguese National Authority of Medicines and Health Products (INFARMED), as interpreted with the Rega algorithm version 8.0.2. A generalized linear mixed model was used to study the time trend of the prevalence of MDR. We observed a statistically significant decrease in the prevalence of MDR over the last decade, from 6.9% (95% CI: 5.7–8.4) in 2001–03, 6.0% (95% CI: 4.9–7.2) in 2003–05, 3.7% (95% CI: 2.8–4.8) in 2005–07 and 1.6% (95% CI: 1.1–2.2) in 2007–09 down to 0.6% (95% CI: 0.3–0.9) in 2009–12 [OR = 0.80 (95% CI: 0.75–0.86); P < 0.001]. In July 2011 the last new case of MDR was seen. The prevalence of multidrug-resistant HIV-1 is decreasing over time in Portugal, reflecting the increasing efficiency of HAART and the availability of new drugs. Therefore, in designing a new drug, safety and practical aspects, e.g. less toxicity and ease of use, may need more attention than focusing mainly on efficacy against resistant strains.