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dc.creatorRhee, SY
dc.creatorClutter, D
dc.creatorFessel, WJ
dc.creatorKlein, D
dc.creatorSlome, S
dc.creatorPinsky, BA
dc.creatorMarcus, JL
dc.creatorHurley, L
dc.creatorSilverberg, MJ
dc.creatorPond, SLK
dc.creatorShafer, RW
dc.date.accessioned2021-01-14T17:00:14Z
dc.date.available2021-01-14T17:00:14Z
dc.date.issued2019-01-07
dc.identifier.issn1058-4838
dc.identifier.issn1537-6591
dc.identifier.doihttp://dx.doi.org/10.34944/dspace/4641
dc.identifier.other29846534 (pubmed)
dc.identifier.urihttp://hdl.handle.net/20.500.12613/4659
dc.description.abstract© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. Background. There are few large studies of transmitted drug resistance (TDR) prevalence and the drug resistance mutations (DRMs) responsible for TDR in the United States. Methods. Human immunodeficiency virus type 1 (HIV-1) reverse transcriptase (RT) and protease sequences were obtained from 4253 antiretroviral therapy (ART)-naive individuals in a California clinic population from 2003 to 2016. Phylogenetic analyses were performed to study linkages between TDR strains and selection pressure on TDR-associated DRMs. Results. From 2003 to 2016, there was a significant increase in overall (odds ratio [OR], 1.05 per year [95% confidence interval {CI}, 1.03-1.08]; P < .001) and nonnucleoside RT inhibitor (NNRTI)-associated TDR (OR, 1.11 per year [95% CI, 1.08-1.15]; P < .001). Between 2012 and 2016, TDR rates to any drug class ranged from 15.7% to 19.2%, and class-specific rates ranged from 10.0% to 12.8% for NNRTIs, 4.1% to 8.1% for nucleoside RT inhibitors (NRTIs), and 3.6% to 5.2% for protease inhibitors. The thymidine analogue mutations, M184V/I and the tenofovir-associated DRMs K65R and K70E/Q/G/N/T accounted for 82.9%, 7.3%, and 1.4% of NRTI-associated TDR, respectively. Thirty-seven percent of TDR strains clustered with other TDR strains sharing the same DRMs. Conclusions. Although TDR has increased significantly in this large cohort, many TDR strains are unlikely to influence the activity of currently preferred first-line ART regimens. The high proportion of DRMs associated with infrequently used regimens combined with the clustering of TDR strains suggest that some TDR strains are being transmitted between ART-naive individuals.
dc.format.extent213-221
dc.language.isoen
dc.relation.haspartClinical Infectious Diseases
dc.relation.isreferencedbyOxford University Press (OUP)
dc.rightsCC BY-NC-ND
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectHIV-1 transmission
dc.subjectHIV-1 drug resistance
dc.subjectmutation
dc.subjectreverse transcriptase
dc.subjectprotease
dc.titleTrends in the Molecular Epidemiology and Genetic Mechanisms of Transmitted Human Immunodeficiency Virus Type 1 Drug Resistance in a Large US Clinic Population
dc.typeArticle
dc.type.genreJournal Article
dc.relation.doi10.1093/cid/ciy453
dc.ada.noteFor Americans with Disabilities Act (ADA) accommodation, including help with reading this content, please contact scholarshare@temple.edu
dc.creator.orcidPond, Sergei L. Kosakovsky|0000-0003-4817-4029
dc.date.updated2021-01-14T17:00:08Z
refterms.dateFOA2021-01-14T17:00:15Z


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