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CROI 2013: Drug-resistant HIV transmission is increasing in NYC immigrant populations

The transmission of drug-resistant HIV among antiretroviral naïve patients is a challenge to antiretroviral initiation and life-long management. In this study, Rachel Chasen from the Mount Sinai School of Medicine discussed the rate of transmitted resistance and impact on HIV outcomes in the diverse immigrant population of NYC.

In this retrospective cohort study, 486 antiretroviral naïve patients seen from 2000 to 2011 at the HIV/AIDS clinic at Elmhurst Hospital Center, Queens, NY, were included. All patients underwent genotypic testing prior to the initiation of antiretroviral therapy, and the Stanford HIV Resistance Database was used as a reference for interpreting the genotype results. Demographic data as well as the time to virologic suppression (<400 copies) were also studied.

Dr. Chasen’s group found that transmitted resistance in this diverse immigrant population is frequent, and that this rate is increasing. In univariate analysis, younger age, lower baseline CD4 count, presence of PCP and male gender were associated with transmitted resistance, but in multivariable analysis, only younger age remained significantly associated with transmitted resistance. Time to virologic suppression was not affected by the presence of transmitted resistance, suggesting that when a regimen is chosen, using knowledge of baseline resistance, prognosis is unaffected.

Chasan R, Sigel K, Karimjee J, and Salama C. Resistance mutations in antiretroviral naïve patients at an urban immigrant HIV clinic. Presented March 5, 2013 at the 20th CROI, Atlanta Georgia. Poster Abstract #616.

Source: Reporting from Atlanta for PRN News: James F Braun, DO