Trends and predictors of transmitted drug resistance (TDR) and clusters with TDR in a local Belgian HIV-1 epidemic
We aimed to study epidemic trends and predictors for transmitted drug resistance (TDR) in our region, its clinical impact and its association with transmission clusters. We included 778 patients from the AIDS Reference Center in Leuven (Belgium) diagnosed from 1998 to 2012. Resistance testing was pe...
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| Veröffentlicht in: | PloS one 2014-07, Vol.9 (7), p.e101738-e101738 |
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| creator | Pineda-Peña, Andrea-Clemencia Schrooten, Yoeri Vinken, Lore Ferreira, Fossie Li, Guangdi Trovão, Nídia Sequeira Khouri, Ricardo Derdelinckx, Inge De Munter, Paul Kücherer, Claudia Kostrikis, Leondios G Nielsen, Claus Littsola, Kirsi Wensing, Annemarie Stanojevic, Maja Paredes, Roger Balotta, Claudia Albert, Jan Boucher, Charles Gomez-Lopez, Arley Van Wijngaerden, Eric Van Ranst, Marc Vercauteren, Jurgen Vandamme, Anne-Mieke Van Laethem, Kristel |
| description | We aimed to study epidemic trends and predictors for transmitted drug resistance (TDR) in our region, its clinical impact and its association with transmission clusters. We included 778 patients from the AIDS Reference Center in Leuven (Belgium) diagnosed from 1998 to 2012. Resistance testing was performed using population-based sequencing and TDR was estimated using the WHO-2009 surveillance list. Phylogenetic analysis was performed using maximum likelihood and Bayesian techniques. The cohort was predominantly Belgian (58.4%), men who have sex with men (MSM) (42.8%), and chronically infected (86.5%). The overall TDR prevalence was 9.6% (95% confidence interval (CI): 7.7-11.9), 6.5% (CI: 5.0-8.5) for nucleoside reverse transcriptase inhibitors (NRTI), 2.2% (CI: 1.4-3.5) for non-NRTI (NNRTI), and 2.2% (CI: 1.4-3.5) for protease inhibitors. A significant parabolic trend of NNRTI-TDR was found (p = 0.019). Factors significantly associated with TDR in univariate analysis were male gender, Belgian origin, MSM, recent infection, transmission clusters and subtype B, while multivariate and Bayesian network analysis singled out subtype B as the most predictive factor of TDR. Subtype B was related with transmission clusters with TDR that included 42.6% of the TDR patients. Thanks to resistance testing, 83% of the patients with TDR who started therapy had undetectable viral load whereas half of the patients would likely have received a suboptimal therapy without this test. In conclusion, TDR remained stable and a NNRTI up-and-down trend was observed. While the presence of clusters with TDR is worrying, we could not identify an independent, non-sequence based predictor for TDR or transmission clusters with TDR that could help with guidelines or public health measures. |
| doi_str_mv | 10.1371/journal.pone.0101738 |
| format | Article |
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We included 778 patients from the AIDS Reference Center in Leuven (Belgium) diagnosed from 1998 to 2012. Resistance testing was performed using population-based sequencing and TDR was estimated using the WHO-2009 surveillance list. Phylogenetic analysis was performed using maximum likelihood and Bayesian techniques. The cohort was predominantly Belgian (58.4%), men who have sex with men (MSM) (42.8%), and chronically infected (86.5%). The overall TDR prevalence was 9.6% (95% confidence interval (CI): 7.7-11.9), 6.5% (CI: 5.0-8.5) for nucleoside reverse transcriptase inhibitors (NRTI), 2.2% (CI: 1.4-3.5) for non-NRTI (NNRTI), and 2.2% (CI: 1.4-3.5) for protease inhibitors. A significant parabolic trend of NNRTI-TDR was found (p = 0.019). Factors significantly associated with TDR in univariate analysis were male gender, Belgian origin, MSM, recent infection, transmission clusters and subtype B, while multivariate and Bayesian network analysis singled out subtype B as the most predictive factor of TDR. Subtype B was related with transmission clusters with TDR that included 42.6% of the TDR patients. Thanks to resistance testing, 83% of the patients with TDR who started therapy had undetectable viral load whereas half of the patients would likely have received a suboptimal therapy without this test. In conclusion, TDR remained stable and a NNRTI up-and-down trend was observed. While the presence of clusters with TDR is worrying, we could not identify an independent, non-sequence based predictor for TDR or transmission clusters with TDR that could help with guidelines or public health measures.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0101738</identifier><identifier>PMID: 25003369</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adult ; Aged ; AIDS ; AIDS (Disease) ; Analysis ; Anti-HIV Agents - pharmacology ; Anti-HIV Agents - therapeutic use ; Bayesian analysis ; Belgium - epidemiology ; Biology ; Biology and Life Sciences ; Cladistic analysis ; Cluster Analysis ; Confidence intervals ; Disease transmission ; DNA polymerases ; Drug resistance ; Drug Resistance, Viral - genetics ; Epidemics ; Epidemiology ; Female ; Gender ; Genotype ; Health aspects ; HIV ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - transmission ; HIV Infections - virology ; HIV-1 - drug effects ; HIV-1 - genetics ; Hospitals ; Human immunodeficiency virus ; Humans ; Immunology ; Infectious diseases ; Inflammatory diseases ; Internal medicine ; Laboratories ; Male ; Medical research ; Medical screening ; Medicine ; Medicine and health sciences ; Microbial Sensitivity Tests ; Middle Aged ; Network analysis ; Nucleoside reverse transcriptase inhibitors ; Patients ; Phylogenetics ; Phylogeny ; Population ; Pregnancy ; Prevalence ; Protease inhibitors ; Proteases ; Proteinase inhibitors ; Public health ; Public Health Surveillance ; Retrospective Studies ; Risk Factors ; RNA-directed DNA polymerase ; Sexually transmitted diseases ; STD ; Studies ; Surveillance ; Therapy ; Trends ; Virology ; Young Adult</subject><ispartof>PloS one, 2014-07, Vol.9 (7), p.e101738-e101738</ispartof><rights>COPYRIGHT 2014 Public Library of Science</rights><rights>2014 Pineda-Peña et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2014 Pineda-Peña et al 2014 Pineda-Peña et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c631t-c5dbab262a1041cc791c1b0e67642f123764853d74d8824cd8ecc9ebf50004bc3</citedby><cites>FETCH-LOGICAL-c631t-c5dbab262a1041cc791c1b0e67642f123764853d74d8824cd8ecc9ebf50004bc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4086934/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4086934/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,550,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25003369$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:129476361$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Pineda-Peña, Andrea-Clemencia</creatorcontrib><creatorcontrib>Schrooten, Yoeri</creatorcontrib><creatorcontrib>Vinken, Lore</creatorcontrib><creatorcontrib>Ferreira, Fossie</creatorcontrib><creatorcontrib>Li, Guangdi</creatorcontrib><creatorcontrib>Trovão, Nídia Sequeira</creatorcontrib><creatorcontrib>Khouri, Ricardo</creatorcontrib><creatorcontrib>Derdelinckx, Inge</creatorcontrib><creatorcontrib>De Munter, Paul</creatorcontrib><creatorcontrib>Kücherer, Claudia</creatorcontrib><creatorcontrib>Kostrikis, Leondios G</creatorcontrib><creatorcontrib>Nielsen, Claus</creatorcontrib><creatorcontrib>Littsola, Kirsi</creatorcontrib><creatorcontrib>Wensing, Annemarie</creatorcontrib><creatorcontrib>Stanojevic, Maja</creatorcontrib><creatorcontrib>Paredes, Roger</creatorcontrib><creatorcontrib>Balotta, Claudia</creatorcontrib><creatorcontrib>Albert, Jan</creatorcontrib><creatorcontrib>Boucher, Charles</creatorcontrib><creatorcontrib>Gomez-Lopez, Arley</creatorcontrib><creatorcontrib>Van Wijngaerden, Eric</creatorcontrib><creatorcontrib>Van Ranst, Marc</creatorcontrib><creatorcontrib>Vercauteren, Jurgen</creatorcontrib><creatorcontrib>Vandamme, Anne-Mieke</creatorcontrib><creatorcontrib>Van Laethem, Kristel</creatorcontrib><title>Trends and predictors of transmitted drug resistance (TDR) and clusters with TDR in a local Belgian HIV-1 epidemic</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>We aimed to study epidemic trends and predictors for transmitted drug resistance (TDR) in our region, its clinical impact and its association with transmission clusters. We included 778 patients from the AIDS Reference Center in Leuven (Belgium) diagnosed from 1998 to 2012. Resistance testing was performed using population-based sequencing and TDR was estimated using the WHO-2009 surveillance list. Phylogenetic analysis was performed using maximum likelihood and Bayesian techniques. The cohort was predominantly Belgian (58.4%), men who have sex with men (MSM) (42.8%), and chronically infected (86.5%). The overall TDR prevalence was 9.6% (95% confidence interval (CI): 7.7-11.9), 6.5% (CI: 5.0-8.5) for nucleoside reverse transcriptase inhibitors (NRTI), 2.2% (CI: 1.4-3.5) for non-NRTI (NNRTI), and 2.2% (CI: 1.4-3.5) for protease inhibitors. A significant parabolic trend of NNRTI-TDR was found (p = 0.019). Factors significantly associated with TDR in univariate analysis were male gender, Belgian origin, MSM, recent infection, transmission clusters and subtype B, while multivariate and Bayesian network analysis singled out subtype B as the most predictive factor of TDR. Subtype B was related with transmission clusters with TDR that included 42.6% of the TDR patients. Thanks to resistance testing, 83% of the patients with TDR who started therapy had undetectable viral load whereas half of the patients would likely have received a suboptimal therapy without this test. In conclusion, TDR remained stable and a NNRTI up-and-down trend was observed. While the presence of clusters with TDR is worrying, we could not identify an independent, non-sequence based predictor for TDR or transmission clusters with TDR that could help with guidelines or public health measures.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adult</subject><subject>Aged</subject><subject>AIDS</subject><subject>AIDS (Disease)</subject><subject>Analysis</subject><subject>Anti-HIV Agents - pharmacology</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Bayesian analysis</subject><subject>Belgium - epidemiology</subject><subject>Biology</subject><subject>Biology and Life Sciences</subject><subject>Cladistic analysis</subject><subject>Cluster Analysis</subject><subject>Confidence intervals</subject><subject>Disease transmission</subject><subject>DNA polymerases</subject><subject>Drug resistance</subject><subject>Drug Resistance, Viral - genetics</subject><subject>Epidemics</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gender</subject><subject>Genotype</subject><subject>Health aspects</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - transmission</subject><subject>HIV Infections - virology</subject><subject>HIV-1 - drug effects</subject><subject>HIV-1 - genetics</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Immunology</subject><subject>Infectious diseases</subject><subject>Inflammatory diseases</subject><subject>Internal medicine</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical screening</subject><subject>Medicine</subject><subject>Medicine and health sciences</subject><subject>Microbial Sensitivity Tests</subject><subject>Middle Aged</subject><subject>Network analysis</subject><subject>Nucleoside reverse transcriptase inhibitors</subject><subject>Patients</subject><subject>Phylogenetics</subject><subject>Phylogeny</subject><subject>Population</subject><subject>Pregnancy</subject><subject>Prevalence</subject><subject>Protease inhibitors</subject><subject>Proteases</subject><subject>Proteinase inhibitors</subject><subject>Public health</subject><subject>Public Health Surveillance</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>RNA-directed DNA polymerase</subject><subject>Sexually transmitted diseases</subject><subject>STD</subject><subject>Studies</subject><subject>Surveillance</subject><subject>Therapy</subject><subject>Trends</subject><subject>Virology</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>D8T</sourceid><sourceid>DOA</sourceid><recordid>eNptUstu1DAUjRCIlsIfILDEpiwy-JXE2SCV8uhIlZDQwNby42bqkrFTO6Hi7_HMpFUHVV7Yuj7n-N7jUxSvCV4Q1pAP12GKXvWLIXhYYIJJw8ST4pi0jJY1xezpg_NR8SKla4wrJur6eXFEK4wZq9vjIq4ieJuQ8hYNEawzY4gJhQ6NUfm0ceMIFtk4rVGE5NKovAF0uvr84_2OY_opjZAZt268QrmMnEcK9cGoHn2Cfu2URxfLXyVBMDgLG2deFs861Sd4Ne8nxc-vX1bnF-Xl92_L87PL0tSMjKWprFaa1lQRzIkxTUsM0Rjqpua0I5TlXVTMNtwKQbmxAoxpQXd5Nsy1YSfF273u0IckZ7uSJBVnDSPZiYxY7hE2qGs5RLdR8a8MysldIcS1VHF0pgdpDRWaYFMpwFxg3eaWsBBaG9IYUDxrlXutdAvDpA_U5tLvfAJZUcxxk_Ef5-4mvQFrwGfD-wPa4Y13V3Id_kiORd2y7YOns0AMNxOkUW5cMtD3ykOYdnNyRhkVbYa--w_6uBszaq3ywM53Ib9rtqLyjJMM4DXZai0eQeW1-9ucxc7l-gGB7wkmhpQidPczEiy3Sb5rRm6TLOckZ9qbh_7ck-6iy_4B1Zzv4A</recordid><startdate>20140708</startdate><enddate>20140708</enddate><creator>Pineda-Peña, 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and predictors of transmitted drug resistance (TDR) and clusters with TDR in a local Belgian HIV-1 epidemic</title><author>Pineda-Peña, Andrea-Clemencia ; Schrooten, Yoeri ; Vinken, Lore ; Ferreira, Fossie ; Li, Guangdi ; Trovão, Nídia Sequeira ; Khouri, Ricardo ; Derdelinckx, Inge ; De Munter, Paul ; Kücherer, Claudia ; Kostrikis, Leondios G ; Nielsen, Claus ; Littsola, Kirsi ; Wensing, Annemarie ; Stanojevic, Maja ; Paredes, Roger ; Balotta, Claudia ; Albert, Jan ; Boucher, Charles ; Gomez-Lopez, Arley ; Van Wijngaerden, Eric ; Van Ranst, Marc ; Vercauteren, Jurgen ; Vandamme, Anne-Mieke ; Van Laethem, Kristel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c631t-c5dbab262a1041cc791c1b0e67642f123764853d74d8824cd8ecc9ebf50004bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adult</topic><topic>Aged</topic><topic>AIDS</topic><topic>AIDS (Disease)</topic><topic>Analysis</topic><topic>Anti-HIV Agents - pharmacology</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Bayesian analysis</topic><topic>Belgium - epidemiology</topic><topic>Biology</topic><topic>Biology and Life Sciences</topic><topic>Cladistic analysis</topic><topic>Cluster Analysis</topic><topic>Confidence intervals</topic><topic>Disease transmission</topic><topic>DNA polymerases</topic><topic>Drug resistance</topic><topic>Drug Resistance, Viral - genetics</topic><topic>Epidemics</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Gender</topic><topic>Genotype</topic><topic>Health aspects</topic><topic>HIV</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - transmission</topic><topic>HIV Infections - virology</topic><topic>HIV-1 - drug effects</topic><topic>HIV-1 - genetics</topic><topic>Hospitals</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Immunology</topic><topic>Infectious diseases</topic><topic>Inflammatory diseases</topic><topic>Internal medicine</topic><topic>Laboratories</topic><topic>Male</topic><topic>Medical research</topic><topic>Medical screening</topic><topic>Medicine</topic><topic>Medicine and health sciences</topic><topic>Microbial Sensitivity Tests</topic><topic>Middle Aged</topic><topic>Network analysis</topic><topic>Nucleoside reverse transcriptase inhibitors</topic><topic>Patients</topic><topic>Phylogenetics</topic><topic>Phylogeny</topic><topic>Population</topic><topic>Pregnancy</topic><topic>Prevalence</topic><topic>Protease inhibitors</topic><topic>Proteases</topic><topic>Proteinase inhibitors</topic><topic>Public health</topic><topic>Public Health Surveillance</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>RNA-directed DNA polymerase</topic><topic>Sexually transmitted diseases</topic><topic>STD</topic><topic>Studies</topic><topic>Surveillance</topic><topic>Therapy</topic><topic>Trends</topic><topic>Virology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pineda-Peña, Andrea-Clemencia</creatorcontrib><creatorcontrib>Schrooten, Yoeri</creatorcontrib><creatorcontrib>Vinken, Lore</creatorcontrib><creatorcontrib>Ferreira, Fossie</creatorcontrib><creatorcontrib>Li, Guangdi</creatorcontrib><creatorcontrib>Trovão, Nídia Sequeira</creatorcontrib><creatorcontrib>Khouri, Ricardo</creatorcontrib><creatorcontrib>Derdelinckx, Inge</creatorcontrib><creatorcontrib>De Munter, Paul</creatorcontrib><creatorcontrib>Kücherer, Claudia</creatorcontrib><creatorcontrib>Kostrikis, Leondios G</creatorcontrib><creatorcontrib>Nielsen, Claus</creatorcontrib><creatorcontrib>Littsola, Kirsi</creatorcontrib><creatorcontrib>Wensing, Annemarie</creatorcontrib><creatorcontrib>Stanojevic, 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titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><collection>Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pineda-Peña, Andrea-Clemencia</au><au>Schrooten, Yoeri</au><au>Vinken, Lore</au><au>Ferreira, Fossie</au><au>Li, Guangdi</au><au>Trovão, Nídia Sequeira</au><au>Khouri, Ricardo</au><au>Derdelinckx, Inge</au><au>De Munter, Paul</au><au>Kücherer, Claudia</au><au>Kostrikis, Leondios G</au><au>Nielsen, Claus</au><au>Littsola, Kirsi</au><au>Wensing, Annemarie</au><au>Stanojevic, Maja</au><au>Paredes, Roger</au><au>Balotta, Claudia</au><au>Albert, Jan</au><au>Boucher, Charles</au><au>Gomez-Lopez, Arley</au><au>Van Wijngaerden, Eric</au><au>Van Ranst, Marc</au><au>Vercauteren, Jurgen</au><au>Vandamme, Anne-Mieke</au><au>Van Laethem, Kristel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trends and predictors of transmitted drug resistance (TDR) and clusters with TDR in a local Belgian HIV-1 epidemic</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2014-07-08</date><risdate>2014</risdate><volume>9</volume><issue>7</issue><spage>e101738</spage><epage>e101738</epage><pages>e101738-e101738</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>We aimed to study epidemic trends and predictors for transmitted drug resistance (TDR) in our region, its clinical impact and its association with transmission clusters. We included 778 patients from the AIDS Reference Center in Leuven (Belgium) diagnosed from 1998 to 2012. Resistance testing was performed using population-based sequencing and TDR was estimated using the WHO-2009 surveillance list. Phylogenetic analysis was performed using maximum likelihood and Bayesian techniques. The cohort was predominantly Belgian (58.4%), men who have sex with men (MSM) (42.8%), and chronically infected (86.5%). The overall TDR prevalence was 9.6% (95% confidence interval (CI): 7.7-11.9), 6.5% (CI: 5.0-8.5) for nucleoside reverse transcriptase inhibitors (NRTI), 2.2% (CI: 1.4-3.5) for non-NRTI (NNRTI), and 2.2% (CI: 1.4-3.5) for protease inhibitors. A significant parabolic trend of NNRTI-TDR was found (p = 0.019). Factors significantly associated with TDR in univariate analysis were male gender, Belgian origin, MSM, recent infection, transmission clusters and subtype B, while multivariate and Bayesian network analysis singled out subtype B as the most predictive factor of TDR. Subtype B was related with transmission clusters with TDR that included 42.6% of the TDR patients. Thanks to resistance testing, 83% of the patients with TDR who started therapy had undetectable viral load whereas half of the patients would likely have received a suboptimal therapy without this test. In conclusion, TDR remained stable and a NNRTI up-and-down trend was observed. While the presence of clusters with TDR is worrying, we could not identify an independent, non-sequence based predictor for TDR or transmission clusters with TDR that could help with guidelines or public health measures.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25003369</pmid><doi>10.1371/journal.pone.0101738</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2014-07, Vol.9 (7), p.e101738-e101738 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1543731386 |
| source | MEDLINE; Public Library of Science; PubMed Central; Directory of Open Access Journals; SWEPUB Freely available online; Free Full-Text Journals in Chemistry; EZB Electronic Journals Library |
| subjects | Acquired immune deficiency syndrome Adult Aged AIDS AIDS (Disease) Analysis Anti-HIV Agents - pharmacology Anti-HIV Agents - therapeutic use Bayesian analysis Belgium - epidemiology Biology Biology and Life Sciences Cladistic analysis Cluster Analysis Confidence intervals Disease transmission DNA polymerases Drug resistance Drug Resistance, Viral - genetics Epidemics Epidemiology Female Gender Genotype Health aspects HIV HIV Infections - drug therapy HIV Infections - epidemiology HIV Infections - transmission HIV Infections - virology HIV-1 - drug effects HIV-1 - genetics Hospitals Human immunodeficiency virus Humans Immunology Infectious diseases Inflammatory diseases Internal medicine Laboratories Male Medical research Medical screening Medicine Medicine and health sciences Microbial Sensitivity Tests Middle Aged Network analysis Nucleoside reverse transcriptase inhibitors Patients Phylogenetics Phylogeny Population Pregnancy Prevalence Protease inhibitors Proteases Proteinase inhibitors Public health Public Health Surveillance Retrospective Studies Risk Factors RNA-directed DNA polymerase Sexually transmitted diseases STD Studies Surveillance Therapy Trends Virology Young Adult |
| title | Trends and predictors of transmitted drug resistance (TDR) and clusters with TDR in a local Belgian HIV-1 epidemic |
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