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The epidemiology of antiretroviral drug resistance among
drug-naive HIV-1-infected persons in 10 US cities.
Journal of Infectious Diseases 2004;189(12):2174-2180.
Weinstock HS, Zaidi I, Heneine W, Bennett D, Garcia-Lerma JG, Douglas
Jr. JM, LaLota M, Dickinson G, Schwarcz S,Torian L, Wendell D, Paul S,
Goza GA, Ruiz J, Boyett B, Kaplan JE.
Abstract
BACKGROUND: The prevalence and characteristics of persons with newly diagnosed
human immunodeficiency virus (HIV) infections with or without evidence of
mutations associated with drug resistance have not been well described. METHODS:
Drug-naive persons in whom HIV had been diagnosed during the previous 12
months and who did not have acquired immune deficiency syndrome were sequentially
enrolled from 39 clinics and testing sites in 10 US cities during 1997-2001.
Genotyping was conducted from HIV-amplification products, by automated sequencing.
For specimens identified as having mutations previously associated with reduced
antiretroviral-drug susceptibility, phenotypic testing was performed. RESULTS:
Of 1311 eligible participants, 1082 (83%) were enrolled and successfully
tested; 8.3% had reverse transcriptase or major protease mutations associated
with reduced antiretroviral-drug susceptibility. The prevalence of these
mutations was 11.6% among men who had sex with men but was only 6.1% and
4.7% among women and heterosexual men, respectively. The prevalence was 5.4%
and 7.9% among African American and Hispanic participants, respectively,
and was 13.0% among whites. Among persons whose sexual partners reportedly
took antiretroviral medications, the prevalence was 15.2%. CONCLUSIONS: Depending
on the characteristics of the patients tested, HIV-genotype testing prior
to the initiation of therapy would identify a substantial number of infected
persons with mutations associated with reduced antiretroviral-drug susceptibility.