title: Trends of prevalence of primary HIV drug resistance in Germany.
abstract: BACKGROUND
  Primary HIV drug resistance (PDR) is associated with poor treatment outcome of first-line highly active antiretroviral therapy (HAART). The aim of the study was to observe the trend of prevalence of PDR between 2001 and 2005.
  
  
  METHODS
  In a prospective multicentre study in the state of Nordrhein-Westfalen, Germany, 831 treatment-naive chronically HIV-infected patients underwent genotypic resistance testing.
  
  
  RESULTS
  Six hundred and forty (77%) of them were male. Two-thirds of the patients (558, 67%) were infected with HIV subtype B. PDR was found in 75 of 831 [9%; 95% confidence interval (CI) 7.1-10.9] cases entering the study between January 2001 and December 2005. An increasing trend of PDR was found from 2001 (4.8%; CI 2.1-9.4) to 2005 (9.0%; CI 5.4-12.6; P = 0.08). A significant tendency to higher PDR was observed for ethnicity other than Caucasian (P = 0.04), HIV subtypes other than B (P = 0.02) and transmission routes other than homosexual (P = 0.03).
  
  
  CONCLUSIONS
  A non-significant increase in prevalence of PDR was observed from 2001 to 2005. A significant trend to higher PDR rate was detected in non-Caucasian patients, patients infected with non-B subtypes, and in patients with risk factors for acquisition of HIV other than homosexual transmission. Based on the fact that there is a trend to higher PDR rate, resistance testing in untreated HIV-infected patients starting HAART becomes more important in clinical routine. The identification of patient subgroups with a remarkable risk of PDR makes continuous monitoring of PDR mandatory.
authors: Clinic for Gastroenterology, Hepatology, and Infectious Diseases, University Clinic Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany. oettem@med.uni-duesseldorf.de
authors: Abdurrahman
authors: A
authors: Sagir
authors: Mark
authors: M
authors: Oette
authors: Rolf
authors: R
authors: Kaiser
authors: Martin
authors: M
authors: Däumer
authors: Gerd
authors: G
authors: Fätkenheuer
authors: Jürgen Kurt
authors: JK
authors: Rockstroh
authors: Heribert
authors: H
authors: Knechten
authors: Günther
authors: G
authors: Schmutz
authors: Martin
authors: M
authors: Hower
authors: Jetske
authors: J
authors: Emmelkamp
authors: Herbert
authors: H
authors: Pfister
authors: Dieter
authors: D
authors: Häussinger
mesh_terms: D024882:Drug Resistance, Viral / Q000235:genetics*; D005006:Ethnicity; D005260:Female; D016679:Genome, Viral / Q000235:genetics; D005838:Genotype; D005858:Germany; D006678:HIV / Q000145:classification / Q000187:drug effects* / Q000235:genetics; D015658:HIV Infections / Q000821:virology*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012725:Sexual Behavior