title: Clinical, epidemiological and treatment failure data among HIV-1 non-B-infected patients in the Spanish AIDS Research Network Cohort.
abstract: BACKGROUND
  The prevalence of HIV-1 non-B variants is increasing in Spain, showing a higher number of transmitted drug resistance mutations (TDR) since 2002. This study presents the features of non-B-infected patients enrolled in the cohort of antiretroviral treatment (ART) naïve HIV-infected patients included in the Research Network on HIV/AIDS (CoRIS).
  
  
  METHODS
  The study includes a selected group of HIV-1 non-B-infected subjects from 670 subjects with pol sequences collected from 2004 to 2008 in the CoRIS cohort. Epidemiological-clinical-virological data were analyzed since cohort entry until October 2011, considering the presence or absence of treatment failure (TF).
  
  
  RESULTS
  Eighty two non-B infected subjects with known HIV-1 variants were selected from 2004 to 2008 in the CoRIS cohort, being mainly female, immigrants, infected by recombinant viruses, and by heterosexual route. They had an intermediate TDR rate (9.4%), a high rate of TF (25.6%), of losses to follow-up (35%), of coinfections (32.9%), and baseline CD4+ counts ≥350cells/mm(3) (61.8%). Non-B subjects with TF showed higher rates of heterosexual infection (85.7% vs. 69.5%, p<0.05), tuberculosis (30.8% vs. 9.1%, p=0.10) and hepatitis C (23.8% vs. 13.9%, p=0.34) coinfections and lower rates of syphilis (0% vs. 21.9%, p<0.05), and had more frequently received first-line ART including protease inhibitors (PIs) than patients without TF (70% vs. 30%, p<0.05). Interestingly, infection with non-B variants reduced the risk of TDR to nucleoside reverse transcriptase inhibitors and increased the risk to PIs.
  
  
  CONCLUSIONS
  HIV-1 non-B-infected patients in Spain had a particular epidemiological and clinical profile that should be considered during their clinical management.
authors.affiliation: HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Universitario Ramón y Cajal-Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Torrecilla García
authors.affiliation: HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Universitario Ramón y Cajal-Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Yebra Sanz
authors.affiliation: HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Universitario Ramón y Cajal-Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Llácer-Delicado
authors.affiliation: HIV Unit, Hospital Universitario 12 de octubre, Madrid, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Rubio García
authors.affiliation: Infectious Diseases Unit, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: González-García
authors.affiliation: Microbiology Department, Hospital Universitario San Cecilio, Granada, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: García García
authors.affiliation: Infectious Diseases Unit, Hospital La Fe, Valencia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: López-Aldeguer
authors.affiliation: Infectious Diseases Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Asensi Álvarez
authors.affiliation: HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Universitario Ramón y Cajal-Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Electronic address: africa.holguin@salud.madrid.org.
authors.forename: África
authors.initials: Á
authors.lastname: Holguín Fernández
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D024882:Drug Resistance, Viral; D054242:Emigrants and Immigrants; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D008297:Male; D013030:Spain / Q000453:epidemiology; D017211:Treatment Failure
chemical_list: D019380:Anti-HIV Agents
keywords: Antiretroviral treatment (ART); CoRIS; Epidemiology; Epidemiología; Fracaso terapéutico (FT) al primer TAR; HIV-1; Non-B variants; Therapeutic failure (TF) to first ART; Tratamiento antiretroviral (TAR); VIH-1; Variantes no-B