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ART-naive MSM source of transmitted drug-resistant HIV
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Most of the sources of transmitted drug-resistant HIV among men who have sex with men were those who had never received antiretroviral therapy, according to data from the Swiss HIV Cohort Study.
“Although it is unclear to what extent our results are generalizable to other risk groups, subtypes or countries, they indicate a high potential of HIV drug resistance to circulate among treatment-naive patients,” the researchers wrote in Clinical Infectious Diseases. “This highlights the importance of limiting the acquisition of drug resistance before it becomes established in untreated patients, and of early test and treat to prevent resistance transmission from untreated patients.”
The study included ART-naive MSM who were infected between 1996 and 2009. From the Swiss HIV Cohort Study and the drug resistance database, the researchers identified 1,674 patients from a surveillance population, and 6,934 patients with HIV for background. Genotypic resistance tests were performed.
Among the patients in the surveillance population, 140 had transmitted drug-resistant HIV and 86 belonged to transmission clusters. Most of the population in clusters could be linked to a potential source. Fifty of the 86 in clusters were clustered with a potential source, and for 35 of the 50, more than one possible source was identified. Among the 66 potential sources, 56 were ART-naive.
“The high proportion of [individuals carrying transmitted drug-resistant HIV] who belonged to Swiss transmission clusters indicates a major role for domestic transmission in the acquisition of transmitted drug resistance in our study population,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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