@article{469300c473fb4a6a94d1fe0019eef35c,
title = "HIV drug resistance in a cohort of HIV-infected MSM in the United States",
abstract = "Objective: To analyze HIV drug resistance among MSM recruited for participation in the HPTN 078 study, which evaluated methods for achieving and maintaining viral suppression in HIV-infected MSM.Methods:Individuals were recruited at four study sites in the United States (Atlanta, Georgia; Baltimore, Maryland; Birmingham, Alabama; and Boston, Massachusetts; 2016-2017). HIV genotyping was performed using samples collected at study screening or enrollment. HIV drug resistance was evaluated using the Stanford v8.7 algorithm. A multiassay algorithm was used to identify individuals with recent HIV infection. Clustering of HIV sequences was evaluated using phylogenetic methods.Results:High-level HIV drug resistance was detected in 44 (31%) of 142 individuals (Atlanta: 21%, Baltimore: 29%, Birmingham: 53%, Boston: 26%); 12% had multiclass resistance, 16% had resistance to tenofovir or emtricitabine, and 8% had resistance to integrase strand transfer inhibitors (INSTIs); 3% had intermediate-level resistance to second-generation INSTIs. In a multivariate model, self-report of ever having been on antiretroviral therapy (ART) was associated with resistance (P=0.005). One of six recently infected individuals had drug resistance. Phylogenetic analysis identified five clusters of study sequences; two clusters had shared resistance mutations.Conclusion:High prevalence of drug resistance was observed among MSM. Some had multiclass resistance, resistance to drugs used for preexposure prophylaxis (PrEP), and INSTI resistance. These findings highlight the need for improved HIV care in this high-risk population, identification of alternative regimens for PrEP, and inclusion of integrase resistance testing when selecting ART regimens for MSM in the United States.",
keywords = "HIV drug resistance, HPTN 078, MSM, United States, phylogenetic analysis",
author = "Fogel, {Jessica M.} and Sivay, {Mariya V.} and Vanessa Cummings and Wilson, {Ethan A.} and Stephen Hart and Theresa Gamble and Oliver Laeyendecker and Fernandez, {Reinaldo E.} and {Del Rio}, Carlos and Batey, {D. Scott} and Mayer, {Kenneth H.} and Farley, {Jason E.} and Laura McKinstry and Hughes, {James P.} and Remien, {Robert H.} and Chris Beyrer and Eshleman, {Susan H.}",
note = "Funding Information: None of the authors have a financial or personal relationship with other people or organizations that could inappropriately influence (bias) their work, with the following exceptions: S.E. has collaborated on research studies with investigators from Abbott Diagnostics; Abbott Diagnostics has provided reagents for collaborative research studies. This work was supported by the HIV Prevention Trials Network (HPTN) sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), National Institute on Drug Abuse (NIDA), and Office of AIDS Research, of the National Institutes of Health (NIH) [UM1-AI068613 (S.H.E.); UM1-AI068617 (Donnell); and UM1-AI068619 (Cohen/El-Sadr)]. Additional support was provided by the Division of Intramural Research, NIAID (O.L.). Funding Information: aDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, bFred Hutchinson Cancer Research Center, Seattle, Washington, cFrontier Science Foundation, Amherst, New York, dFHI 360, Durham, North Carolina, eNIAID, National Institutes of Health, fDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, gEmory University Rollins School of Public Health and School of Medicine, Atlanta, Georgia, hDepartment of Social Work, University of Alabama at Birmingham, Birmingham, Alabama, iDepartment of Medicine, Harvard Medical School, jFenway Institute, Boston, Massachusetts, kJohns Hopkins University School of Nursing, Baltimore, Maryland, lDepartment of Biostatistics, University of Washington, Seattle, Washington, mHIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute and Columbia University, New York, New York, and nDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. Correspondence to Susan H. Eshleman, MD, PhD, Department of Pathology, The Johns Hopkins Medical Institutions, Ross Building, Room 646, 720 Rutland Avenue, Baltimore, MD 21205, USA. Tel: +1 410 614 4734; fax: +1 410 502 9244; e-mail: seshlem@jhmi.edu Received: 19 March 2019; revised: 4 September 2019; accepted: 15 September 2019. Publisher Copyright: Copyright {\textcopyright} 2019 The Author(s).",
year = "2020",
month = jan,
day = "1",
doi = "10.1097/QAD.0000000000002394",
language = "English (US)",
volume = "34",
pages = "91--101",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "1",
}