Antoniadou, ZA

Buckton, AJ

Haidich, AB

Kollaras, P

Malisiovas, N

Mbisa, JL

Metallidis, S

Nikolaidis, P

Papadimitriou, E

Papoutsi, A

Pilalas, D

Skoura, L

Tsachouridou, O

Valagouti, D

English

PubMed

L Skoura

S Metallidis

AJ Buckton

JL Mbisa

D Pilalas

E Papadimitriou

A Papoutsi

AB Haidich

D Valagouti

O Tsachouridou

ZA Antoniadou

P Kollaras

P Nikolaidis

N Malisiovas

Springer - Publisher Connector

POSTER PRESENTATION Open Access
Transmitted drug resistance associated with
transmission clusters in newly diagnosed
antiretroviral-naïve patients in Northern Greece
L Skoura1*, S Metallidis2, AJ Buckton3, JL Mbisa3, D Pilalas2, E Papadimitriou1, A Papoutsi1, AB Haidich4,
D Valagouti2, O Tsachouridou2, ZA Antoniadou1, P Kollaras2, P Nikolaidis2, N Malisiovas1
From Tenth International Congress on Drug Therapy in HIV Infection
Glasgow, UK. 7-11 November 2010
Purpose of the study
To determine the contribution of transmission clusters
on transmitted drug resistance (TDR) in newly diag-
nosed antiretroviral naive patients in Northern Greece,
during 2000 -2007.
Methods
Viral reverse transcriptase and protease genes from 369
individuals with newly diagnosed HIV-1 infection were
sequenced at baseline. A maximum-likelihood phyloge-
netic analysis method was employed to examine for
linkage between viral isolates. Clinical data were
retrieved from the database and cross-referenced with
the patients’ medical files. Transmitted drug resistance
was defined in accordance with the Surveillance Drug
Resistance Mutation (SDRM) 2009 list.
Results
The study population characteristics were as follows:
82.8% male, 89.7% of Greek nationality, mean age 38,
median CD4 cell count at diagnosis 295 cells/µl and
mean HIV-1 RNA 4.94 log10 copies/ml. The most pre-
valent risk exposure category was men who have sex
with men 59.1% (n=218) followed by heterosexual
transmission 21.4% (n=79) and intravenous drug use
7.6% (n=28). Subtype B viruses were most prevalent
(53.1%), followed by subtype A (32.5%). At least one
drug resistance mutation was identified in 46/369
patients (12.4%). Twenty-eight patients (7.6%) harbored
resistance mutations to nucleoside/nucleotide RT inhi-
bitors, 20 patients (5.4%) to non-nucleoside RT inhibi-
tors and 12 patients (3.3%) to protease inhibitors (PIs).
Dual-class resistance mutations were identified in 14
patients (3.8%). The median CD4 cell count in patients
with TDR was not significantly different compared to
patients without (p=0.072). Phylogenetic analyses, sup-
ported by bootstrapping >90% and genetic distance
<0.015, revealed three transmission clusters involving
drug resistant strains, including one cluster of 11
patients infected with a strain carrying RT mutations
Y181C and T215 variants conferring NRTI and NNRTI
resistance.
Conclusions
The overall prevalence of TDR in our study population
was 12.4%. Phylogenetic analyses of viral sequences
from these new diagnoses demonstrated the impact of
transmission clusters on the primary drug resistance.
The outbreak of dual-class TDR, coupled with late HIV
diagnosis in this population may require improved pub-
lic health interventions.
Author details
1Medical School, Aristotle University of Thessaloniki, National AIDS Reference
Center of Northern Greece, Thessaloniki, Greece. 2AHEPA University Hospital,
Medical School, Aristotle University of Thessaloniki, Infectious Diseases
Division, Thessaloniki, Greece. 3Health Protection Agency, Colindale, Virus
Reference Department, Centre for Infections, London, UK. 4Medical School,
Aristotle University of Thessaloniki, Department of Hygiene, Thessaloniki,
Greece.
Published: 8 November 2010
1Medical School, Aristotle University of Thessaloniki, National AIDS Reference
Center of Northern Greece, Thessaloniki, Greece
Full list of author information is available at the end of the article
Skoura et al. Journal of the International AIDS Society 2010, 13(Suppl 4):P125
http://www.jiasociety.org/content/13/S4/P125
© 2010 Skoura et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
Reference
. Bennett DE, Camacho RJ, Otelea D, et al: Drug Resistance Mutations for
Surveillance of Transmitted HIV-1 Drug-Resistance. PLOS ON 2009, 4:
e4724, 2009 Update.
doi:10.1186/1758-2652-13-S4-P125
Cite this article as: Skoura et al.: Transmitted drug resistance associated
with transmission clusters in newly diagnosed antiretroviral-naïve
patients in Northern Greece. Journal of the International AIDS Society 2010
13(Suppl 4):P125.
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Page 2 of 2


Transmitted drug resistance associated with transmission clusters in newly diagnosed antiretroviral-naïve patients in Northern Greece

Buckton, A

Mbisa, J

Haidich, A

Antoniadou, Z

DSpace at NTUA

Drug Resistance Mutations for Surveillance of Transmitted

Submit your next manuscript to BioMed Central and take full advantage of: • Convenient online submission • Thorough peer review • No space constraints or color ﬁgure charges • Immediate publication on acceptance

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3112900

Transmitted drug resistance associated with transmission clusters in newly diagnosed antiretroviral-naïve patients in Northern Greece

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