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Genes 2017, 8(11), 322; doi:10.3390/genes8110322

Transmission Dynamics of HIV-1 Drug Resistance among Treatment-Naïve Individuals in Greece: The Added Value of Molecular Epidemiology to Public Health

1
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece
2
1st Department of Internal Medicine, G. Genimatas GH, 11527 Athens, Greece
3
3rd Internal Medicine Department-Infectious Diseases, Red Cross Hospital, 11526 Athens, Greece
4
5th Department of Medicine and Infectious Diseases, Evaggelismos GH, 10676 Athens, Greece
5
Hellenic Center for Disease Control & Prevention, 15123 Athens, Greece
6
4th Department of Medicine, Attikon GH, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
7
1st Department of Medicine, Laikon GH, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
8
Department of Internal Medicine, Tzaneio GH, 18536 Piraeus, Greece
9
HIV/AIDS Unit, A. Syngros Hospital of Dermatology and Venereology, 16121 Athens, Greece
10
HIV Unit, 2nd Department of Internal Medicine, Hippokration GH, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
11
Department of Pathophysiology, Laikon GH, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
12
2nd Department of Internal Medicine, Sismanogleion GH, 15126 Athens, Greece
13
Department of Internal Medicine, University GH, Democritus University of Thrace, 67100 Alexandroupolis, Greece
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editor: Thierry Wirth
Received: 3 September 2017 / Revised: 5 November 2017 / Accepted: 6 November 2017 / Published: 13 November 2017
(This article belongs to the Section Microbial Genetics and Genomics)
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Abstract

The presence of human immunodeficiency virus type 1 (HIV-1) drug resistance among drug-naïve patients remains stable, although the proportion of patients with virological failure to therapy is decreasing. The dynamics of transmitted resistance among drug-naïve patients remains largely unknown. The prevalence of non-nucleoside reverse transcriptase inhibitors (NNRTI) resistance was 16.9% among treatment-naïve individuals in Greece. We aimed to investigate the transmission dynamics and the effective reproductive number (Re) of the locally transmitted NNRTI resistance. We analyzed sequences with dominant NNRTI resistance mutations (E138A and K103N) found within monophyletic clusters (local transmission networks (LTNs)) from patients in Greece. For the K103N LTN, the Re was >1 between 2008 and the first half of 2013. For all E138A LTNs, the Re was >1 between 1998 and 2015, except the most recent one (E138A_4), where the Re was >1 between 2006 and 2011 and approximately equal to 1 thereafter. K103N and E138A_4 showed similar characteristics with a more recent origin, higher Re during the first years of the sub-epidemics, and a declining trend in the number of transmissions during the last two years. In the remaining LTNs the epidemic was still expanding. Our study highlights the added value of molecular epidemiology to public health. View Full-Text
Keywords: HIV; molecular epidemiology; drug resistance; transmission dynamics; effective reproductive number HIV; molecular epidemiology; drug resistance; transmission dynamics; effective reproductive number
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Paraskevis, D.; Kostaki, E.; Gargalianos, P.; Xylomenos, G.; Lazanas, M.; Chini, M.; Skoutelis, A.; Papastamopoulos, V.; Paraskeva, D.; Antoniadou, A.; Papadopoulos, A.; Psichogiou, M.; Daikos, G.L.; Chrysos, G.; Paparizos, V.; Kourkounti, S.; Sambatakou, H.; Sipsas, N.V.; Lada, M.; Panagopoulos, P.; Maltezos, E.; Drimis, S.; Hatzakis, A. Transmission Dynamics of HIV-1 Drug Resistance among Treatment-Naïve Individuals in Greece: The Added Value of Molecular Epidemiology to Public Health. Genes 2017, 8, 322.

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