NMU Receptors

The prevalence of TDR to NNRTI was low (three patients only) whereas no resistance to PIs was detected

The prevalence of TDR to NNRTI was low (three patients only) whereas no resistance to PIs was detected. mostly to the men having sex with men (MSM). The majority of patients with main resistance carried SDRM associated with resistance to nucleoside analogues reverse transcriptase inhibitors (NRTIs, 23 of 118 patients, 19.5%). The most frequently found NRTI SDRM was T215S (17 of 118 patients, 14.4%). SDRM associated with resistance to nonnucleoside reverse transcriptase inhibitors were detected in three (2.5%) patients and primary resistance to protease inhibitors was not detected. Non-B subtypes were detected in 13/118 patients (11%). A total of 12 transmission pairs and eight unique transmission clusters were identified with the largest cluster harboring sequences from 19 patients; among them all but two were transporting the T215S mutation. This study showed a high prevalence of TDR in newly diagnosed MSM from Croatia and is an important contribution concerning the relationship between local transmission clusters and the spread of resistant computer virus. Introduction Croatia is usually a small South European country with a populace of 4.3 million people. 1 Despite numerous socioeconomic and political changes in the past decades, a transition toward a market-driven economy, as well as life loses and migrations during the war for independence (1991C1995), no increase in the prevalence of HIV contamination has been observed in recent years.2 A total of 862 persons have been diagnosed with HIV contamination in the period 1985C2010 in Croatia.3 However, the proportion of men who have sex with men (MSM) among newly diagnosed patients with HIV infection is increasing (up to 80% in recent years) and a concentrated epidemics among MSM might be emerging.4 Clinical care of HIV patients in Croatia is centralized and all patients are treated exclusively at the HIV/AIDS center of the University Hospital for Infectious Diseases (UHID) in Zagreb.2 The health care insurance system is universal and antiretroviral treatment is free of charge for all those citizens. Noteworthy, you will find fewer antiretroviral drugs available in Croatia compared to European Union (EU) countries. For example, in 2009 2009, out of 26 antiretroviral drugs registered in the EU, only 14 were available in Croatia.5 The majority of HIV-1 infections in Croatia are associated with subtype B. Molecular analysis of HIV subtypes in 145 Croatian patients (2001C2003) from different risk groups showed that 26% of infections were due to UNC0379 non-B subtypes (predominantly CRF02_AG, subtype C, subtype A, and CRF10_CD).6 Non-B subtype infections were found only in Croatian patients with heterosexual exposure (predominantly seafarers and their steady female partners) whereas HIV epidemics in MSM were due to UNC0379 subtype B infections only.6 A more recent respondent-driven sampling (RDS) study around the prevalence of HIV, sexually transmitted infections, and risky sexual behaviors among MSM from the capital of Croatia (Zagreb) confirmed the predominance of subtype B infections within this risk group.7,8 Transmission of antiretroviral drug-resistant HIV strains from treated patients who have experienced a suboptimal response to treatment or treatment failure to treatment-naive patients has been reported in both developed countries with long-term access to antiretroviral drugs as well as in developing countries with limited project-driven access to treatment. However, the data around the PIK3C2B prevalence of transmitted drug resistance (TDR) reported in various studies are often not directly comparable, mainly due to the different methodological methods (sampling strategy, etc.) and criteria for interpretation of main resistance mutation significance (surveillance drug resistance mutations list recommended by the World Health Organization in 2009 2009 versus other algorithms for the analysis of drug resistance mutations).9,10 The reported prevalence of TDR in Europe ranges between 0% and 25%.11C33 The prevalence of transmitted drug resistance in Europe has been carefully monitored via the surveillance program SPREAD. UNC0379 A recent report around the SPREAD UNC0379 program by Vercauteren sequences from 637 newly diagnosed HIV patients from Geneva showed that transmission clusters were more frequent in patients with TDR.24 Yerly suggested an important contribution of transmission clusters as a self-fuelling mechanism of TDR.24 In this study, by using phylogenetic analysis, we also evaluated the contribution of transmission clusters to the spread of resistant computer virus in newly diagnosed treatment-naive HIV-infected MSM from Croatia. Materials and Methods Study design and patients The study enrolled treatment-naive patients who were diagnosed with HIV-1 contamination at the Croatian Reference center for HIV/AIDS and UHID between January 2006 and December 2008, were 18 years old, provided.