Trends in transmitted drug-resistant HIV-1 and demographic characteristics of newly diagnosed patients: nationwide surveillance from 2003 to 2008 in Japan.
The emergence and transmission of drug-resistant human immunodeficiency virus-1 (HIV-1) compromises antiretroviral treatment for HIV-1. Thus, testing for drug resistance is recommended at diagnosis and before initiating highly active antiretroviral treatment. We conducted an epidemiological study enrolling newly diagnosed patients between 2003 and 2008 in our nationwide surveillance network. In the 6-year study period, the prevalence of drug-resistant HIV-1 among 2573 patients, consisting mainly of Japanese men in their late-30s and infected through male-to-male sexual contacts, followed an increasing trend from 5.9% (16/273) in 2003 to 8.3% (50/605) in 2008. Nucleoside reverse transcriptase inhibitor-associated mutations predominated in each year, with T215 revertants being the most abundant. The predictive factor for drug-resistant HIV-1 transmission was subtype B (OR=2.36; p=0.004), and those for recent HIV-1 infection were male gender (OR=3.79; p=0.009), MSM behavior (OR=1.67; p=0.01), Japanese nationality (OR=2.31; p=0.008), and subtype B (OR=5.64; p<0.05). Continued activities are needed to raise awareness of the risks of HIV-1 infection and complications of drug-resistant strains. Continued surveillance is also needed to understand trends in the HIV-1 epidemic.
Hattori
Junko
J
National Hospital Organization, Nagoya Medical Center, Clinical Research Center, 4-1-1 Sannomaru, Naka-ku, Nagoya 4600001, Japan.
Shiino
Teiichiro
T
Gatanaga
Hiroyuki
H
Yoshida
Shigeru
S
Watanabe
Dai
D
Minami
Rumi
R
Sadamasu
Kenji
K
Kondo
Makiko
M
Mori
Haruyo
H
Ueda
Mikio
M
Tateyama
Masao
M
Ueda
Atsuhisa
A
Kato
Shingo
S
Ito
Toshihiro
T
Oie
Masayasu
M
Takata
Noboru
N
Hayashida
Tsunefusa
T
Nagashima
Mami
M
Matsuda
Masakazu
M
Ibe
Shiro
S
Ota
Yasuo
Y
Sasaki
Satoru
S
Ishigatsubo
Yoshiaki
Y
Tanabe
Yoshinari
Y
Koga
Ichiro
I
Kojima
Yoko
Y
Yamamoto
Masahiro
M
Fujita
Jiro
J
Yokomaku
Yoshiyuki
Y
Koike
Takao
T
Shirasaka
Takuma
T
Oka
Shinichi
S
Sugiura
Wataru
W
D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D016022:Case-Control Studies; D003625:Data Collection; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics*; D018451:Homosexuality, Male; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009154:Mutation; D016133:Polymerase Chain Reaction; D011159:Population Surveillance; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D012725:Sexual Behavior; D016896:Treatment Outcome
D019380:Anti-HIV Agents; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors