G. Rocheleau, C.J. Brumme, J. Shoveller, V.D. Lima, P.R. Harrigan

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Presentation transcript:

Longitudinal trends of HIV drug resistance in a large Canadian cohort, 1996–2016 G. Rocheleau, C.J. Brumme, J. Shoveller, V.D. Lima, P.R. Harrigan Clinical Microbiology and Infection Volume 24, Issue 2, Pages 185-191 (February 2018) DOI: 10.1016/j.cmi.2017.06.014 Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions

Clinical Microbiology and Infection 2018 24, 185-191DOI: (10. 1016/j Clinical Microbiology and Infection 2018 24, 185-191DOI: (10.1016/j.cmi.2017.06.014) Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions

Fig. 1 Percentage of transmitted HIV drug resistance, and acquired HIV drug resistance (detected as of April 2016) among treatment naïve participants initiating cART in a given year (N=6543). In the primary plot, drug resistance mutations were determined using major mutations in the IAS-USA (2015) mutation list. The inset plot shows the percentage of participants with drug resistance detected pre-therapy initiation in a given year, broken down by category of drug resistance. Drug categories include lamivudine/emtricitabine (3TC/FTC), other nucleoside reverse transcriptase inhibitors (Other nRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI), and protease inhibitors (PI). Individuals who have never received a resistance test (N=1260) were assumed to have no drug resistance. Clinical Microbiology and Infection 2018 24, 185-191DOI: (10.1016/j.cmi.2017.06.014) Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions

Fig. 2 Percentage of participants with acquired drug resistance mutations detected in a given drug category by years after cART initiation. Drug resistance mutations are as defined in Fig. 1. Kaplan-Meier plots are shown for individuals that initiated cART between (a) 1996 and 2000, (b) 2001 and 2005, (c) 2006 and 2010, and (d) 2011 and 2014. For each drug category, log-rank tests compared the survival curves between different eras; all gave p <0.0001. (e) Acquired drug resistance for entire duration of study. Log-rank test compared the survival curves between drug categories, giving a p-value of 0.055. Clinical Microbiology and Infection 2018 24, 185-191DOI: (10.1016/j.cmi.2017.06.014) Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions

Fig. 3 Multivariable odds ratios for the development of acquired drug resistance associated with regimen adherence, per era of cART initiation. (a) A cross-era comparison of odds ratios for developing drug resistance within a single adherence level. The multivariable logistic regression model for A was stratified by level of adherence. (b) A cross-adherence level comparison of odds ratios for developing drug resistance within each era. The multivariable logistic regression model for (b) was stratified by era of therapy initiation. Variables that were included in the models used in (a) and (b) were the same as listed in Table S1. Clinical Microbiology and Infection 2018 24, 185-191DOI: (10.1016/j.cmi.2017.06.014) Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions