title: Trends in Transmission of Drug Resistance and Prevalence of Non-B Subtypes in Patients with Acute or Recent HIV-1 Infection in Barcelona in the Last 16 Years (1997-2012).
abstract: OBJECTIVE
  To evaluate the prevalence of transmitted drug resistance (TDR) and non-B subtypes in patients with acute/recent HIV-1 infection in Barcelona during the period 1997-2012.
  
  
  METHODS
  Patients from the "Hospital Clínic Primary HIV-1 Infection Cohort" with a genotyping test performed within 180 days of infection were included. The 2009 WHO List of Mutations for Surveillance of Transmitted HIV-1 Drug Resistance was used for estimating the prevalence of TDR and phylogenetic analysis for subtype determination.
  
  
  RESULTS
  189 patients with acute/recent HIV-1 infection were analyzed in 4 time periods (1997-2000, n=28; 2001-4, n=42; 2005-8, n=55 and 2009-12, n=64). The proportion of patients with acute/recent HIV-1 infection with respect to the total of newly HIV-diagnosed patients in our center increased over the time and was 2.18%, 3.82%, 4.15% and 4.55% for the 4 periods, respectively (p=0.005). The global prevalence of TDR was 9%, or 17.9%, 9.5%, 3.6% and 9.4% by study period (p=0.2). The increase in the last period was driven by protease-inhibitor and nucleoside-reverse-transcriptase-inhibitor resistance mutations while non-nucleoside-reverse-transcriptase inhibitor TDR and TDR of more than one family decreased. The overall prevalence of non-B subtypes was 11.1%, or 0%, 4.8%, 9.1% and 20.3 by study period (p=0.01). B/F recombinants, B/G recombinants and subtype F emerged in the last period. We also noticed an increase in the number of immigrant patients (p=0.052). The proportion of men-who-have-sex-with-men (MSM) among patients with acute/recent HIV-1 infection increased over the time (p=0.04).
  
  
  CONCLUSIONS
  The overall prevalence of TDR in patients with acute/recent HIV-1 infection in Barcelona was 9%, and it has stayed relatively stable in recent years. Non-B subtypes and immigrants proportions progressively increased.
authors.affiliation: Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Ambrosioni
authors.affiliation: Huésped Foundation, Buenos Aires, Argentina.
authors.forename: Omar
authors.initials: O
authors.lastname: Sued
authors.affiliation: Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Nicolas
authors.affiliation: Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Parera
authors.affiliation: Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: María
authors.initials: M
authors.lastname: López-Diéguez
authors.affiliation: Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain.
authors.forename: Anabel
authors.initials: A
authors.lastname: Romero
authors.affiliation: Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Agüero
authors.affiliation: Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Department of Microbiology. Barcelona Centre for International Health Research (CRESIB) Hospital Clínic, Barcelona, Spain.
authors.forename: María Ángeles
authors.initials: MÁ
authors.lastname: Marcos
authors.affiliation: Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: Christian
authors.initials: C
authors.lastname: Manzardo
authors.affiliation: Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Zamora
authors.affiliation: Institute for Biomedical Research in Retroviruses and AIDS, Buenos Aires, Argentina.
authors.forename: Manuel
authors.initials: M
authors.lastname: Gómez-Carrillo
authors.affiliation: Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Gatell
authors.affiliation: Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: Tomás
authors.initials: T
authors.lastname: Pumarola
authors.affiliation: Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Miró
mesh_terms: D000208:Acute Disease; D000328:Adult; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000235:genetics / Q000635:transmission; D015497:HIV-1 / Q000235:genetics / Q000472:pathogenicity; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010802:Phylogeny; D015995:Prevalence; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology