1283. PRE TREATMENT HIV-1 DRUG RESISTANCE IN TRANSMISSION CLUSTERS OF THE COLOGNE-BONN REGION, GERMANY
Session: Poster Abstract Session: HIV: Molecular Epidemiology
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • ID-Week 2018 PRE TREATMENT HIV-1 DRUG RESISTANCE 19.09.2018 ms.pdf (1014.3 kB)
  • Background: In Germany, previous reports have demonstrated transmitted HIV-1 drug resistance mutations (DRM) in 10% of newly diagnosed individuals, affecting treatment failure and the choice of antiretroviral therapy (ART). Here, we sought to understand the molecular epidemiology of HIV DRM transmission throughout the Cologne-Bonn region, an area with one of the highest rate of new HIV infections in Europe (13.7 per 100,000 habitants).

    Methods: We analyzed 714 HIV-1 ART naïve infected individuals diagnosed at the University Hospitals Cologne and Bonn between 2001 and 2016. Screening for DRM was performed according to the Stanford University Genotypic Resistance Interpretation. Shared DRM were defined as any DRM present in genetically linked individuals (<1.5% genetic distance). Phylogenetic and network analyses were performed to infer putative relationships and shared DRMs.

    Results: We detected 123 DRMs in our study population (17.2% of all sequences). Prevalence of any DRM was comparable among risk groups and was highest among people from an endemic area (i.e. country with HIV prevalence >1%) (11/51, 21.6%). Nucleoside-and non-nucleoside reverse transcriptase inhibitor (NRTI/NNNRTI) resistance mutations were detected in 49 (7%) and 97 (13.6%) individuals, with the E138A in 29 (4.1%) and K103N in 11 (1.5%) being the most frequent. Frequency of DRM was comparable in clustering and not clustering individuals (17.1% versus 17.5%). Transmission network analysis indicated that the frequency of DRM in clustering individuals was the highest in PWID (3/7, 42.9%) (Fig 1A). Genetically linked individuals harboring shared DRMs were more likely to live in suburban areas than in Central Cologne (18.8% vs. 8% of clustering sequences with DRM; Figure 1B).

    Conclusion: The rate of DRMs was exceptionally high in the Cologne/Bonn, area. Network analysis elucidated frequent cases of shared DRMs among genetically linked individuals, revealing the potential spread of DRMs and the need to prevent onward transmission of DRM in the Cologne-Bonn area.


    Melanie Stecher, MSc. Public Health1,2, Martin Hoenigl, MD3, Anna-Maria Eis-Huebinger, Prof.4, Clara Lehmann, PD Dr. med.1,2, Gerd Fätkenheuer, Univ.-Prof. Dr. med.1,2, Jan-Christian Wasmuth, MD4, Elena Knops, PhD2, Sanjay Metha, Prof.3, Janne Vehreschild, Prof. Dr. med.1,2 and Antoine Chaillon, MD, PhD3, (1)German Center for Infection Research, Cologne-Bonn, Cologne, Germany, (2)University Hospital of Cologne, Cologne, Germany, (3)University of California San Diego, San Diego, CA, (4)University Hopital of Bonn, Bonn, Germany

    Disclosures:

    M. Stecher, None

    M. Hoenigl, Gilead, Basilea, Merck: Speaker's Bureau , Research grant and Speaker honorarium .

    A. M. Eis-Huebinger, None

    C. Lehmann, None

    G. Fätkenheuer, None

    J. C. Wasmuth, None

    E. Knops, None

    S. Metha, None

    J. Vehreschild, None

    A. Chaillon, None

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