title: Characteristics of Transmitted Drug-Resistant HIV-1 in Recently Infected Treatment-Naive Patients in Japan.
abstract: OBJECTIVE
  Progress in antiretroviral treatment has led to fewer virological failure cases, but 10%-20% of treatment-naive HIV/AIDS cases are reported to harbor drug-resistant strains, suggesting transmission of drug-resistant HIV. We aimed to determine the trend in prevalence of transmitted drug-resistant (TDR) HIV in Japan, particularly in recently infected patients.
  
  
  METHODS
  Drug-resistance test was performed on 3904 HIV-1-infected cases newly diagnosed between 2007 and 2012. The number of cases infected within 6 months [recent seroconverters (RS)] was estimated by BED assay of 2700 plasma samples. Characteristics of RS cases were further analyzed.
  
  
  RESULTS
  The overall prevalence of TDR was 9.1%, ranging from 7.3% in 2008% to 12.5% in 2010. Among 1403 subtype B/E/D cases with >50 CD4 T cell counts and >1000 HIV copies per milliliter, 468 (33.4%) were estimated to be RS. The prevalence of RS was significantly higher among cases who were male, Japanese, and men who have sex with men. The prevalence of TDR did not differ significantly between recent and long-term seroconverters (8.5% vs. 9.2%, respectively, P = 0.68). Common mutations in both groups were M46I/L and T215 revertants. Furthermore, sequences with these mutations, K103N and D30N/N88D formed clusters on phylogenetic trees.
  
  
  CONCLUSIONS
  Our study clarified an increase in prevalence of TDR in Japan from 2007 to 2012. The phylogenetic clustering of cases with M46I/L or T215 revertants suggests that HIV with these mutations have become circulating strains. Furthermore, detailed analyses showed that Japanese men who have sex with men are more aware of their risk of HIV infection.
authors.affiliation: *Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; †Currently, HIV Dynamics and Replication Program, National Cancer Institute, National Institutes of Health, MD; ‡Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; §National Center for Global Health and Medicine, Tokyo, Japan; ‖Osaka Prefectural Institute of Public Health, Osaka, Japan; ¶National Hospital Organization Kyushu Medical Center, Fukuoka, Japan; #Saitama Institute of Public Health; **Tokyo Metropolitan Institute of Public Health, Tokyo, Japan; ††Kanagawa Prefectural Institute of Public Health, Chigasaki, Japan; ‡‡Division of Basic Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan; and §§Currently, GlaxoSmithKline KK, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Hattori
authors.forename: Teiichiro
authors.initials: T
authors.lastname: Shiino
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Gatanaga
authors.forename: Haruyo
authors.initials: H
authors.lastname: Mori
authors.forename: Rumi
authors.initials: R
authors.lastname: Minami
authors.forename: Kazue
authors.initials: K
authors.lastname: Uchida
authors.forename: Kenji
authors.initials: K
authors.lastname: Sadamasu
authors.forename: Makiko
authors.initials: M
authors.lastname: Kondo
authors.forename: Wataru
authors.initials: W
authors.lastname: Sugiura
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology*; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission / Q000821:virology*; D015497:HIV-1 / Q000145:classification / Q000187:drug effects* / Q000235:genetics; D018451:Homosexuality, Male; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009154:Mutation; D010802:Phylogeny; D015995:Prevalence
chemical_list: D019380:Anti-HIV Agents