title: Missing data on the estimation of the prevalence of accumulated human immunodeficiency virus drug resistance in patients treated with antiretroviral drugs in north america.
abstract: Determination of the prevalence of accumulated antiretroviral drug resistance among persons infected with human immunodeficiency virus (HIV) is complicated by the lack of routine measurement in clinical care. By using data from 8 clinic-based cohorts from the North American AIDS Cohort Collaboration on Research and Design, drug-resistance mutations from those with genotype tests were determined and scored using the Genotypic Resistance Interpretation Algorithm developed at Stanford University. For each year from 2000 through 2005, the prevalence was calculated using data from the tested subset, assumptions that incorporated clinical knowledge, and multiple imputation methods to yield a complete data set. A total of 9,289 patients contributed data to the analysis; 3,959 had at least 1 viral load above 1,000 copies/mL, of whom 2,962 (75%) had undergone at least 1 genotype test. Using these methods, the authors estimated that the prevalence of accumulated resistance to 2 or more antiretroviral drug classes had increased from 14% in 2000 to 17% in 2005 (P < 0.001). In contrast, the prevalence of resistance in the tested subset declined from 57% to 36% for 2 or more classes. The authors' use of clinical knowledge and multiple imputation methods revealed trends in HIV drug resistance among patients in care that were markedly different from those observed using only data from patients who had undergone genotype tests.
authors.affiliation: Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street,Suite E7640, Baltimore, MD 21205, USA. aabraham@jhsph.edu
authors.forename: Alison G
authors.initials: AG
authors.lastname: Abraham
authors.forename: Bryan
authors.initials: B
authors.lastname: Lau
authors.forename: Steven
authors.initials: S
authors.lastname: Deeks
authors.forename: Richard D
authors.initials: RD
authors.lastname: Moore
authors.forename: Jinbing
authors.initials: J
authors.lastname: Zhang
authors.forename: Joseph
authors.initials: J
authors.lastname: Eron
authors.forename: Richard
authors.initials: R
authors.lastname: Harrigan
authors.forename: M John
authors.initials: MJ
authors.lastname: Gill
authors.forename: Mari
authors.initials: M
authors.lastname: Kitahata
authors.forename: Marina
authors.initials: M
authors.lastname: Klein
authors.forename: Sonia
authors.initials: S
authors.lastname: Napravnik
authors.forename: Anita
authors.initials: A
authors.lastname: Rachlis
authors.forename: Benigno
authors.initials: B
authors.lastname: Rodriguez
authors.forename: Sean
authors.initials: S
authors.lastname: Rourke
authors.forename: Constance
authors.initials: C
authors.lastname: Benson
authors.forename: Ron
authors.initials: R
authors.lastname: Bosch
authors.forename: Ann
authors.initials: A
authors.lastname: Collier
authors.forename: Kelly
authors.initials: K
authors.lastname: Gebo
authors.forename: James
authors.initials: J
authors.lastname: Goedert
authors.forename: Robert
authors.initials: R
authors.lastname: Hogg
authors.forename: Michael
authors.initials: M
authors.lastname: Horberg
authors.forename: Lisa
authors.initials: L
authors.lastname: Jacobson
authors.forename: Amy
authors.initials: A
authors.lastname: Justice
authors.forename: Greg
authors.initials: G
authors.lastname: Kirk
authors.forename: Jeff
authors.initials: J
authors.lastname: Martin
authors.forename: Rosemary
authors.initials: R
authors.lastname: McKaig
authors.forename: Michael
authors.initials: M
authors.lastname: Silverberg
authors.forename: Timothy
authors.initials: T
authors.lastname: Sterling
authors.forename: Jennifer
authors.initials: J
authors.lastname: Thorne
authors.forename: James
authors.initials: J
authors.lastname: Willig
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Gange
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D024921:Drug Resistance, Multiple, Viral; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009656:North America / Q000453:epidemiology; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics; D012189:Retrospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data*; D013997:Time Factors
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral