Amb motiu del tancament d'estiu, la validació de documents es reprendrà a partir del 28 d'agost de 2026. Disculpeu les molèsties.
Con motivo del cierre de verano, la validación de documentos se reanudará a partir del 28 de agosto de 2026. Disculpad las molestias
Due to the summer closure, document validation will resume starting August 28, 2026. We apologize for any inconvenience.

Files

641599.pdf (294.1 KB)

Document type

Article

Version

Published version

Publication date

2014-03-17

Publication license

cc-by (c) Monge, Susana et al., 2014
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/109725

Clinically relevant transmitted drug resistance to first line antiretroviral drugs and implications for recommendations

Journal Title

Authors

Director/Tutor

Journal ISSN

Volume Title

Related resource

https://doi.org/10.1371/journal.pone.0090710

Abstract

Background The aim was to analyse trends in clinically relevant resistance to first-line antiretroviral drugs in Spain, applying the Stanford algorithm, and to compare these results with reported Transmitted Drug Resistance (TDR) defined by the 2009 update of the WHO SDRM list. Methods We analysed 2781 sequences from ARV naive patients of the CoRIS cohort (Spain) between 2007-2011. Using the Stanford algorithm "Low-level resistance", "Intermediate resistance" and "High-level resistance" categories were considered as "Resistant". Results 70% of the TDR found using the WHO list were relevant for first-line treatment according to the Stanford algorithm. A total of 188 patients showed clinically relevant resistance to first-line ARVs [6.8% (95%Confidence Interval: 5.8-7.7)], and 221 harbored TDR using the WHO list [7.9% (6.9-9.0)]. Differences were due to a lower prevalence in clinically relevant resistance for NRTIs [2.3% (1.8-2.9) vs. 3.6% (2.9-4.3) by the WHO list] and PIs [0.8% (0.4-1.1) vs. 1.7% (1.2-2.2)], while it was higher for NNRTIs [4.6% (3.8-5.3) vs. 3.7% (3.0-4.7)]. While TDR remained stable throughout the study period, clinically relevant resistance to first line drugs showed a significant trend to a decline (p = 0.02). Conclusions Prevalence of clinically relevant resistance to first line ARVs in Spain is decreasing, and lower than the one expected looking at TDR using the WHO list. Resistance to first-line PIs falls below 1%, so the recommendation of screening for TDR in the protease gene should be questioned in our setting. Cost-effectiveness studies need to be carried out to inform evidence-based recommendations.

Subject

Antiretrovirals, Resistència als medicaments, VIH (Virus), Estudi de casos, Espanya

Subject (English)

Antiretroviral agents, Drug resistance, HIV (Viruses), Case studies, Spain

Citation

Collections

Articles publicats en revistes (Medicina)

Citation

MONGE CORELLA, Susana, et al. Clinically relevant transmitted drug resistance to first line antiretroviral drugs and implications for recommendations. PLoS One. 2014. Vol. 9, num. 3, pags. e90710. ISSN 1932-6203. [consulted: 16 of August of 2026]. Available at: https://hdl.handle.net/2445/109725

Export metadata

JSON - METS

Share record