HIV drug resistance in a cohort of HIV-infected MSM in the United States

Jessica M. Fogel, Mariya V. Sivay, Vanessa Cummings, Ethan A. Wilson, Stephen Hart, Theresa Gamble, Oliver Laeyendecker, Reinaldo E. Fernandez, Carlos Del Rio, D. Scott Batey, Kenneth H. Mayer, Jason E. Farley, Laura McKinstry, James P. Hughes, Robert H. Remien, Chris Beyrer, Susan H. Eshleman

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)91-101
Number of pages11
JournalAIDS (London, England)
Volume34
Issue number1
DOIs
StatePublished - Jan 1 2020

Fingerprint

Drug Resistance
Integrases
HIV
Baltimore
Tenofovir
Self Report
HIV Infections
Cluster Analysis
Mutation
Therapeutics
Population

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Fogel, J. M., Sivay, M. V., Cummings, V., Wilson, E. A., Hart, S., Gamble, T., ... Eshleman, S. H. (2020). HIV drug resistance in a cohort of HIV-infected MSM in the United States. AIDS (London, England), 34(1), 91-101. https://doi.org/10.1097/QAD.0000000000002394

HIV drug resistance in a cohort of HIV-infected MSM in the United States. / Fogel, Jessica M.; Sivay, Mariya V.; Cummings, Vanessa; Wilson, Ethan A.; Hart, Stephen; Gamble, Theresa; Laeyendecker, Oliver; Fernandez, Reinaldo E.; Del Rio, Carlos; Batey, D. Scott; Mayer, Kenneth H.; Farley, Jason E.; McKinstry, Laura; Hughes, James P.; Remien, Robert H.; Beyrer, Chris; Eshleman, Susan H.

In: AIDS (London, England), Vol. 34, No. 1, 01.01.2020, p. 91-101.

Research output: Contribution to journalArticle

Fogel, JM, Sivay, MV, Cummings, V, Wilson, EA, Hart, S, Gamble, T, Laeyendecker, O, Fernandez, RE, Del Rio, C, Batey, DS, Mayer, KH, Farley, JE, McKinstry, L, Hughes, JP, Remien, RH, Beyrer, C & Eshleman, SH 2020, 'HIV drug resistance in a cohort of HIV-infected MSM in the United States', AIDS (London, England), vol. 34, no. 1, pp. 91-101. https://doi.org/10.1097/QAD.0000000000002394
Fogel, Jessica M. ; Sivay, Mariya V. ; Cummings, Vanessa ; Wilson, Ethan A. ; Hart, Stephen ; Gamble, Theresa ; Laeyendecker, Oliver ; Fernandez, Reinaldo E. ; Del Rio, Carlos ; Batey, D. Scott ; Mayer, Kenneth H. ; Farley, Jason E. ; McKinstry, Laura ; Hughes, James P. ; Remien, Robert H. ; Beyrer, Chris ; Eshleman, Susan H. / HIV drug resistance in a cohort of HIV-infected MSM in the United States. In: AIDS (London, England). 2020 ; Vol. 34, No. 1. pp. 91-101.
@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.",
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.}",
year = "2020",
month = "1",
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",

}

TY - JOUR

T1 - HIV drug resistance in a cohort of HIV-infected MSM in the United States

AU - Fogel, Jessica M.

AU - Sivay, Mariya V.

AU - Cummings, Vanessa

AU - Wilson, Ethan A.

AU - Hart, Stephen

AU - Gamble, Theresa

AU - Laeyendecker, Oliver

AU - Fernandez, Reinaldo E.

AU - Del Rio, Carlos

AU - Batey, D. Scott

AU - Mayer, Kenneth H.

AU - Farley, Jason E.

AU - McKinstry, Laura

AU - Hughes, James P.

AU - Remien, Robert H.

AU - Beyrer, Chris

AU - Eshleman, Susan H.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85075960090&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85075960090&partnerID=8YFLogxK

U2 - 10.1097/QAD.0000000000002394

DO - 10.1097/QAD.0000000000002394

M3 - Article

C2 - 31634196

AN - SCOPUS:85075960090

VL - 34

SP - 91

EP - 101

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 1

ER -