- How many people are initially infected with resistant virus?
- Transmission of drug-resistant HIV in resource-limited settings
- Factors in transmission of drug-resistant HIV
- Infectiousness and persistence of drug-resistant virus
- Implications for prognosis
- The "New York Case"
- Superinfection[ix]
- Resistance in genital fluids and other bodily tissues
Factors in transmission of drug-resistant HIV
A study of 21 recently infected injecting drug users and 56 individuals who contracted HIV through sexual activity found no difference in the rate of transmission, suggesting no difference in the transmissibility of drug-resistant viruses by blood or by sexual intercourse [1].
Sexually transmitted infections have been found to significantly increase the risk of drug-resistant HIV transmission [2]. In gay men, crystal methamphetamine use has been tied to the transmission of NNRTI-resistant virus [3].
As discussed above, prevalence of transmitted resistance varies according to the class of drug. In chronically infected, untreated people, NRTI resistance remains the most prevalent form of resistance [4].
Data from the United States showed that the proportion of people contracting PI-resistant virus rose from less than 1% between 1996 and 1998 to 8% between 1999 and 2000 [5].
Transmission of NNRTI-resistant virus is becoming more common in the United States. Rates of NNRTI-resistant virus were about 1% between 1996 and 1998 and rose to 7% between 1999 and 2000[6]. A study of 225 people with recent HIV infection who presented to the San Francisco General Hospital between June 1996 and June 2001 found that the overall prevalence of resistant strains in 2000 to 2001 was 27%, similar to the 25% prevalence found in 1996 and 1997. However, while the prevalence of PI- and NRTI-resistant virus remained fairly stable over time, the prevalence of NNRTI-related resistance rose from 0 to 13% over the same period, and resistance to two drug classes increased concomitantly[7].latest aidsmap news
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