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Acute HIV infection: impact on the spread of HIV and transmission of drug resistance

S. Yerly, S. Vora, P. Rizzardi, J.-P. Chave, P. L. Vernazza, M. Flepp, A. Telenti, M. Battegay, A.-L. Veuthey, J.-P. Bru, M. Rickenbach, B. Hirschel (+1 others)
2001 AIDS (London)  
and the Swiss HIV Cohort Study à Objective: To assess the impact of primary HIV infection (PHI) on the spread of HIV and the temporal trends in transmission of HIV drug resistance between 1996 and 1999 in Switzerland. Methods: Sequencing of the genes for reverse transcriptase (RT) and protease was performed for 197 individuals with documented PHI. Phylogenetic analyses were confronted with epidemiological data. Results: Signi®cant clustering was demonstrated for 29% of the RT sequences. All
more » ... sequences. All these cases occurred closely together in place and time; contact tracing demonstrated transmission at the time of PHI in 30% of them. Genotypic drug resistance was detected in 8.variants were identi®ed in 11.3% of individuals infected by homosexual contacts, 6.1% by heterosexual contacts, 13% of intravenous drug users and more frequently in men (10.4%) than women (2.6%). Potential factors involved in the recent decrease of transmission of drug-resistant variants include increase of HIV non-B subtypes from 23% in 1996 to 35% in 1999 (only one non-B subtype had resistance mutations) and a steady increase of patients with undetectable viraemia as documented in Swiss HIV Cohort Study (10% in 1996 vs 53% in 1999. Conclusions: Phylogenetic and epidemiological analyses underline the impact of PHI in the spread of HIV. Moreover, this study indicates that drug resistance transmission may have decreased recently in Switzerland through the increased frequency of infection with HIV non-B subtypes and the steady increase of patients with undetectable viraemia.
doi:10.1097/00002030-200111230-00010 pmid:11698702 fatcat:3combtov3veolhowdulbtymsbu