title: Epidemiology of transmitted drug resistance in chronically HIV-infected patients in Germany: the RESINA study 2001-2009.
abstract: OBJECTIVE
  Transmitted HIV drug resistance may impair treatment efficacy of combination antiretroviral therapy (ART). This study describes the epidemiology of transmitted resistance in chronically infected patients.
  
  
  METHODS
  In a prospective multicenter trial in Nordrhein-Westfalen, Germany, transmitted drug resistance was determined by genotypic resistance testing in patients on initiation of first-line ART.
  
  
  RESULTS
  From 2001 to 2009, 2,078 patients were enrolled in the study. 79.9% were male, 81.2% were Caucasians, and a homosexual transmission mode was found in 51.3%. Of these patients, 41.5% were at the stage of AIDS, median CD4 cell count was 230/μl, and median viral load was 64.466 copies/ml. Transmitted drug resistance mutations were seen in 9.2% (95% CI, 7.9-10.4). Resistance in the nucleoside reverse transcriptase inhibitor class was found in 5.8% (4.8-6.8), in the nonnucleoside reverse transcriptase inhibitor class in 2.8% (2.1-3.6), and in the protease inhibitor class in 2.7% (2.0-3.4). After a continuous increase to a level above 10% in the years 2006 and 2007, a decline of drug resistance prevalence followed in 2008 and 2009.
  
  
  CONCLUSIONS
  Transmitted HIV drug resistance was found in around 10% of chronically infected patients in Germany who started their ART. We showed a moderate decline of the prevalence of mutant virus strains in recent years. Further surveillance of this phenomenon is mandatory.
authors.affiliation: Clinic for General Medicine, Gastroenterology and Infectious Diseases, Augustinerinnen Hospital, Cologne, Germany. m.oette@koeln-kh-augustinerinnen.de
authors.forename: Mark
authors.initials: M
authors.lastname: Oette
authors.forename: Stefan
authors.initials: S
authors.lastname: Reuter
authors.forename: Rolf
authors.initials: R
authors.lastname: Kaiser
authors.forename: Thomas
authors.initials: T
authors.lastname: Lengauer
authors.forename: Gerd
authors.initials: G
authors.lastname: Fätkenheuer
authors.forename: Heribert
authors.initials: H
authors.lastname: Knechten
authors.forename: Martin
authors.initials: M
authors.lastname: Hower
authors.forename: Herbert
authors.initials: H
authors.lastname: Pfister
authors.forename: Dieter
authors.initials: D
authors.lastname: Häussinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000494:pharmacology*; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D005858:Germany / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission / Q000821:virology*; D015497:HIV-1 / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058889:Molecular Typing; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents