Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
Shopping Cart: ( empty )
You are here: Home > Journals > SH > SH04048
REVIEW
Contents Vol 2(3)

Managing patients with sexual transmission of drug-resistant HIV

Valerio Tozzi A B , Angela Corpolongo A , Rita Bellagamba A and Pasquale Narciso A
+ Author Affiliations
- Author Affiliations

A National Institute for Infectious Diseases Lazzaro Spallanzani, Via Portuense 292, 00149 Rome, Italy.

B Corresponding author. Email: tozzi@inmi.it

Sexual Health 2(3) 135-142 https://doi.org/10.1071/SH04048
Submitted: 28 October 2004  Accepted: 2 June 2005   Published: 20 September 2005

Abstract

The transmission of drug-resistant HIV-1 (primary HIV resistance) is a cause of growing concern. The prevalence of drug-resistant variants in patients with primary HIV-1 infection (PHI) ranges from 10 to 36%. Unlike patients with secondary resistance, patients with primary HIV resistance do not show a rapid conversion to wild-type drug-sensitive virus in the absence of treatment. Moreover, primary HIV-1 resistance is associated with higher rates of treatment failure. Rapid diagnosis is important, since early events in PHI may have a critical role in disease progression. An early diagnosis is also essential to prevent HIV-1 transmission during the high viremic phase of PHI. This review focuses on prevalence, basic principles, diagnostic markers, and approaches for the treatment of PHI due to sexual transmission of drug-resistant HIV-1. The aim of the paper is to help clinicians to deal with patients presenting a PHI due to drug-resistant variants.

Additional keywords: HIV drug resistance, primary HIV infection, resistance mutations, transmission.


Acknowledgements

We thank Dr Andre B. Stoler for editing the manuscript.


References


[1] Devereux HL,  Youle M,  Johnson MA,  Loveday C. Rapid decline in detectability of HIV-1 drug resistance mutations after stopping therapy. AIDS 1999; 13 123–7.
| Crossref | GoogleScholarGoogle Scholar |

[2] Miller V,  Sabin C,  Hertogs K,  Bloor S,  Martinez-Picado J,  D’Aquila R, et al. Virological and immunological effects of treatment interruptions in HIV-1 infected patients with treatment failure. AIDS 2000; 14 2857–67.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[3] Delaugerre C,  Morand-Joubert L,  Chaix ML,  Picard O,  Marcelin AG,  Schneider V, et al. Persistence of multidrug-resistant HIV-1 without antiretroviral treatment 2 years after sexual transmission. Antivir Ther 2004; 9 415–21.
| PubMed |

[4] Barbour JD,  Hecht FM,  Wrin T,  Liegler TJ,  Ramstead CA,  Busch MP, et al. Persistence of primary drug resistance among recently HIV-1 infected adults. AIDS 2004; 18 1683–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[5] Brenner BG,  Routy JP,  Petrella M,  Moisi D,  Oliveira M,  Detorio M, et al. Persistence and fitness of multidrug-resistant human immunodeficiency virus type 1 acquired in primary infection. J Virol 2002; 76 1753–61.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[6] de Ronde A,  van Dooren M,  van Der Hoek L,  Bouwhuis D,  de Rooij E,  van Gemen B, et al. Establishment of new transmissible and drug-sensitive human immunodeficiency virus type 1 wild types due to transmission of nucleoside analogue-resistant virus. J Virol 2001; 75 595–602.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[7] Hecht FM,  Grant RM,  Petropoulos CJ,  Dillon B,  Chesney MA,  Tian H, et al. Sexual transmission of an HIV-1 variant resistant to multiple reverse-transcriptase and protease inhibitors. N Engl J Med 1998; 339 307–11.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[8] Yerly S,  Kaiser L,  Race E,  Bru J-P,  Clavel F,  Perrin L. Transmission of antiretroviral-drug-resistant HIV-1 variants. Lancet 1999; 354 729–33.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[9] Boden D,  Hurley A,  Zhang L,  Cao Y,  Guo Y,  Jones E, et al. HIV-1 drug resistance in newly infected individuals. JAMA 1999; 282 1135–41.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[10] Salomon H,  Wainberg MA,  Brenner B,  Quan Y,  Rouleau D,  Cote P, et al. Primary infection study. Prevalence of HIV-1 resistant to antiretroviral drugs in 81 individuals newly infected by sexual contact or injecting drug use. AIDS 2000; 4 F17–23.
| Crossref | GoogleScholarGoogle Scholar |

[11] Chaix ML,  Descamps D,  Harzic M,  Schneider V,  Deveau C,  Tamalet C, et al. Table prevalence of genotypic drug resistance mutations but increase in non-B virus among patients with primary HIV-1 infection in France. AIDS 2003; 17 2635–43.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[12] UK Collaborative Group on Monitoring the Transmission of HIV Drug Resistance Analysis of prevalence of HIV-1 drug resistance in primary infections in the United Kingdom. BMJ 2001; 322 1087–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[13] Brenner B,  Wainberg MA,  Salomon H,  Rouleau D,  Dascal A,  Spira B, et al. Resistance to antiretroviral drugs in patients with primary HIV-1 infection. Investigators of the Quebec Primary Infection Study. Int J Antimicrob Agents 2000; 16 429–34.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[14] Little SJ,  Holte S,  Routy JP,  Daar ES,  Markowitz M,  Collier AC, et al. Antiretroviral-drug resistance among patients recently infected with HIV. N Engl J Med 2002; 347 385–94.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[15] Little SJ,  Holte S,  Routy JP,  Connick E,  Daar ES,  Conway B, et al. Longitudinal analysis of transmitted drug resistance among recently HIV-infected subjects in North America. Antivir Ther 2002; 7 S188– .


[16] Grant RM,  Hecht FM,  Warmerdam M,  Liu L,  Liegler T,  Petropoulos CJ, et al. Time trends in primary HIV-1 drug resistance among recently infected persons. JAMA 2002; 288 181–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[17] Bezemer D,  Jurriaans S,  Prins M,  van der Hoek L,  Prins JM,  de Wolf F, et al. Declining trend in transmission of drug-resistant HIV-1 in Amsterdam. AIDS 2004; 18 1571–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[18] Simon V,  Vanderhoeven J,  Hurley A,  Ramratnam B,  Louie M,  Dawson K, et al. Evolving patterns of HIV-1 resistance to antiretroviral agents in newly infected individuals. AIDS 2002; 16 1511–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[19] Johnson VA,  Brun-Vezinet F,  Clotet B,  Conway B,  D’Aquila RT,  Demeter LM, et al. Drug resistance mutations in HIV-1. Top HIV Med 2003; 11 215–21.
| PubMed |

[20] Cunningham CK,  Chaix ML,  Rekacewicz C,  Britto P,  Rouzioux C,  Gelber RD, et al. Development of resistance mutations in women receiving standard antiretroviral therapy who received intrapartum nevirapine to prevent perinatal human immunodeficiency virus type 1 transmission: a substudy of pediatric AIDS clinical trials group protocol 316. J Infect Dis 2002; 186 181–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[21] Jourdain G,  Ngo-Giang-Huong N,  Le Coeur S,  Bowonwatanuwong C,  Kantipong P,  Leechanachai P, et al. Intrapartum exposure to nevirapine and subsequent maternal responses to nevirapine-based antiretroviral therapy. N Engl J Med 2004; 351 229–40.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[22] Barbour JD,  Wrin T,  Grant RM,  Martin JN,  Segal MR,  Petropoulos CJ, et al. Evolution of phenotypic drug susceptibility and viral replication capacity during long-term virologic failure of protease inhibitor therapy in human immunodeficiency virus-infected adults. J Virol 2002; 76 11104–12.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[23] Martinez-Picado J,  Savara AV,  Sutton L,  DAquila RT. Replicative fitness of protease inhibitor-resistant mutants of human immunodeficiency virus type 1. J Virol 1999; 73 3744–52.
| PubMed |

[24] Nijhuis M,  Schuurman R,  de Jong D,  Erickson J,  Gustchina E,  Albert J, et al. Increased fitness of drug resistant HIV-1 protease as a result of acquisition of compensatory mutations during suboptimal therapy. AIDS 1999; 13 2349–59.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[25] Yerly S,  Stephanie J,  Telenti A,  Flepp M,  Kaiser L,  Chave J-P, et al. Infrequent transmission of HIV-1-drug-resistant variants. Antivir Ther 2004; 9 375–84.
| PubMed |

[26] Veazey RS,  DeMaria M,  Chalifoux LV,  Shvetz DE,  Pauley DR,  Knight HL, et al. Gastrointestinal tract as a major site of CD4+ T cell depletion and viral replication in SIV infection. Science 1998; 280 427–31.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[27] Ahlgren DJ. Role of primary infection in epidemics of HIV in gay cohorts. J Acquir Immune Defic Syndr Hum Retrovirol 1996; 11 204– .
| PubMed |

[28] UNAIDS. Global summary of the HIV/AIDS epidemic. December 2000. Geneva: UN; 2000.

[29] Narciso P,  Galgani S,  Del Grosso B,  De Marco M,  De Santis A,  Balestra P, et al. Acute disseminated encephalomyelitis as manifestation of primary HIV infection. Neurology 2001; 25 1493–6.


[30] Durant J,  Clevenbergh P,  Halfon P,  Delgiudice P,  Porsin S,  Simonet P, et al. Drug-resistance genotyping in HIV-1 therapy: the VIRADAPT randomized controlled trial. Lancet 1999; 353 2195–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[31] Baxter JD,  Mayers DL,  Wentworth DN,  Neaton JD,  Hoover ML,  Winters MA, et al. A randomized study of antiretroviral management based on plasma genotypic antiretroviral resistance testing in patients failing therapy. AIDS 2000; 14 F83–93.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[32] Department of Health and Human Services (DHHS). Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. March 23, 2004. Available online at: www.hivatis.org (verified August 2005).

[33] Hirsch M S,  Brun-Vezinet F,  Clotet B,  Conway B,  Kuritzkes D R,  D’Aquila R T, et al. Antiretroviral drug resistance testing in adults infected with human immunodeficiency virus type 1: 2003 Recommendations of an international AIDS society–USA panel. Clin Infect Dis 2003; 37 113–28.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[34] The EuroGuidelines Group for HIV Resistance Clinical and laboratory guidelines for the use of HIV-1 drug resistance testing as a part of treatment management: recommendations for the European setting. AIDS 2001; 15 309–20.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[35] Pozniak A , Gazzard B , Anderson J , Babiker A , Churchill D , Collins S , et al British HIV Association (BHIVA) guidelines for the treatment of HIV-infected adults with antiretroviral therapy. July 2003. Available online at: www.bhiva.org (verified August 2005).

[36] Yeni PG,  Hammer SM,  Hirsch MS. Treatment for adult HIV infection. 2004 Recommendations of the international AIDS Society–USA panel. J Am Med Assoc 2004; 292 251–65.
| Crossref | GoogleScholarGoogle Scholar |

[37] Mocroft A,  Devereux H,  Kinloch-de-Loes S,  Wilson D,  Madge S,  Youle M, et al. Immunological, virological and clinical response to highly active antiretroviral therapy treatment regimens in a complete clinic population. Royal Free Center for HIV Medicine. AIDS 2000; 14 1545–52.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[38] Lucas JM,  Chaisson RE,  Moore RD. Highly active antiretroviral therapy in a large urban clinic: risk factors for virologic failure and adverse drug reactions. Ann Intern Med 1999; 131 81–7.
| PubMed |

[39] Richman DD,  Morton SC,  Wrin T,  Hellmann N,  Berry S,  Shapiro MF, et al. The prevalence of antiretroviral drug resistance in the United States. AIDS 2004; 18 1393–401.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[40] Quinn TC,  Wawer MJ,  Sewankambo N,  Serwadda D,  Li C,  Wabwire-Mangen F, et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med 2000; 342 921–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[41] Daar ES,  Moudgil T,  Meyer RD,  Ho DD. Transient high levels of viremia in patients with primary human immunodeficiency virus type 1 infection. N Engl J Med 1991; 324 961–4.
| PubMed |

[42] Tindall B,  Evans L,  Cunningham P,  McQueen P,  Hurren L,  Vasak E, et al. Identification of HIV-1 in semen following primary HIV-1 infection. AIDS 1992; 6 949–52.
| PubMed |

[43] Taylor S,  Cane P,  Hue S,  Xu L,  Wrin T,  Lie Y, et al. Identification of a transmission chain of HIV type 1 containing drug resistance-associated mutations. AIDS Res Hum Retroviruses 2003; 19 353–61.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[44] Almeda J , Casabona J Allepuz A Bolao F Campins M Colom J , et al. Guidelines for non-occupational post-exposure HIV prophylaxis. Recommendations of the GESIDA/CEESCAT/National Plan on AIDS. Available online at: www.gesidaseimc.com (verified August 2005).

[45] Pinkerton SD,  Martin JN,  Roland ME,  Katz MH,  Coates TJ,  Kahn JO. Cost-effectiveness of postexposure prophylaxis after sexual or injection-drug exposure to human immunodeficiency virus. Arch Intern Med 2004; 164 46–54.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[46] Jackson JB,  Barnett S,  Piwowar-Manning E,  Apuzzo L,  Raines C,  Hendrix C, et al. A phase I/II study of nevirapine for pre-exposure prophylaxis of HIV-1 transmission in uninfected subjects at high risk. AIDS 2003; 17 547–53.
| Crossref | GoogleScholarGoogle Scholar | PubMed |