Missing data on the estimation of the prevalence of accumulated human immunodeficiency virus drug resistance in patients treated with antiretroviral drugs in North America

Alison G. Abraham, Bryan Lau, Steven Deeks, Richard D. Moore, Jinbing Zhang, Joseph Eron, Richard Harrigan, M. John Gill, Mari Kitahata, Marina Klein, Sonia Napravnik, Anita Rachlis, Benigno Rodriguez, Sean Rourke, Constance Benson, Ron Bosch, Ann Collier, Kelly Gebo, James Goedert, Robert HoggMichael Horberg, Lisa Jacobson, Amy Justice, Greg Kirk, Jeff Martin, Rosemary Mckaig, Michael Silverberg, Timothy Sterling, Jennifer Thorne, James Willig, Stephen J. Gange

Research output: Contribution to journalArticle

Abstract

Determination of the prevalence of accumulated antiretroviral drug resistance among persons infected with human immunodeficiency virus (HIV) is complicated by the lack of routine measurement in clinical care. By using data from 8 clinic-based cohorts from the North American AIDS Cohort Collaboration on Research and Design, drug-resistance mutations from those with genotype tests were determined and scored using the Genotypic Resistance Interpretation Algorithm developed at Stanford University. For each year from 2000 through 2005, the prevalence was calculated using data from the tested subset, assumptions that incorporated clinical knowledge, and multiple imputation methods to yield a complete data set. A total of 9,289 patients contributed data to the analysis; 3,959 had at least 1 viral load above 1,000 copies/mL, of whom 2,962 (75%) had undergone at least 1 genotype test. Using these methods, the authors estimated that the prevalence of accumulated resistance to 2 or more antiretroviral drug classes had increased from 14% in 2000 to 17% in 2005 (P < 0.001). In contrast, the prevalence of resistance in the tested subset declined from 57% to 36% for 2 or more classes. The authors' use of clinical knowledge and multiple imputation methods revealed trends in HIV drug resistance among patients in care that were markedly different from those observed using only data from patients who had undergone genotype tests.

Original languageEnglish (US)
Pages (from-to)727-735
Number of pages9
JournalAmerican journal of epidemiology
Volume174
Issue number6
DOIs
StatePublished - Sep 15 2011
Externally publishedYes

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Keywords

  • HIV
  • antiretroviral therapy, highly active
  • drug resistance
  • genotype

ASJC Scopus subject areas

  • Epidemiology

Cite this

Abraham, A. G., Lau, B., Deeks, S., Moore, R. D., Zhang, J., Eron, J., Harrigan, R., Gill, M. J., Kitahata, M., Klein, M., Napravnik, S., Rachlis, A., Rodriguez, B., Rourke, S., Benson, C., Bosch, R., Collier, A., Gebo, K., Goedert, J., ... Gange, S. J. (2011). Missing data on the estimation of the prevalence of accumulated human immunodeficiency virus drug resistance in patients treated with antiretroviral drugs in North America. American journal of epidemiology, 174(6), 727-735. https://doi.org/10.1093/aje/kwr141