Transmission Cluster of Multiclass Highly Drug-Resistant HIV-1 Among 9 Men Who Have Sex With Men in Seattle/King County, WA, 2005-2007
BACKGROUND:From 2005 through 2007, Seattle health care providers identified cases of primary multiclass drug-resistant (MDR) HIV-1 with common patterns of resistance to antiretrovirals (ARVs). Through surveillance activities and genetic analysis, the local Health Department and the University of Was...
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Published in: | Journal of acquired immune deficiency syndromes (1999) Vol. 49; no. 2; pp. 205 - 211 |
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Main Authors: | , , , , , , , , , , , , |
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Language: | English |
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Hagerstown, MD
Lippincott Williams & Wilkins, Inc
01-10-2008
Lippincott Williams & Wilkins Lippincott Williams & Wilkins Ovid Technologies |
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Abstract | BACKGROUND:From 2005 through 2007, Seattle health care providers identified cases of primary multiclass drug-resistant (MDR) HIV-1 with common patterns of resistance to antiretrovirals (ARVs). Through surveillance activities and genetic analysis, the local Health Department and the University of Washington identified phylogenetically linked cases among ARV treatment-naive and -experienced individuals.
METHODS:HIV-1 pol nucleotide consensus sequences submitted to the University of Washington Clinical Virology Laboratory were assessed for phylogenetically related MDR HIV. Demographic and clinical data collected included HIV diagnosis date, ARV history, and laboratory results.
RESULTS:Seven ARV-naive men had phylogenetically linked MDR strains with resistance to most ARVs; these were linked to 2 ARV-experienced men. All 9 men reported methamphetamine use and multiple anonymous male partners. Primary transmissions were diagnosed for more than a 2-year period, 2005-2007. Three, including the 2 ARV-experienced men, were prescribed ARVs.
CONCLUSIONS:This cluster of 9 men with phylogenetically related highly drug-resistant MDR HIV strains and common risk factors but without reported direct epidemiologic links may have important implications to public health. This cluster demonstrates the importance of primary resistance testing and of collaboration between the public and private medical community in identifying MDR outbreaks. Public health interventions and surveillance are needed to reduce transmission of MDR HIV-1. |
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AbstractList | From 2005 through 2007, Seattle health care providers identified cases of primary multiclass drug-resistant (MDR) HIV-1 with common patterns of resistance to antiretrovirals (ARVs). Through surveillance activities and genetic analysis, the local Health Department and the University of Washington identified phylogenetically linked cases among ARV treatment-naive and -experienced individuals.
HIV-1 pol nucleotide consensus sequences submitted to the University of Washington Clinical Virology Laboratory were assessed for phylogenetically related MDR HIV. Demographic and clinical data collected included HIV diagnosis date, ARV history, and laboratory results.
Seven ARV-naive men had phylogenetically linked MDR strains with resistance to most ARVs; these were linked to 2 ARV-experienced men. All 9 men reported methamphetamine use and multiple anonymous male partners. Primary transmissions were diagnosed for more than a 2-year period, 2005-2007. Three, including the 2 ARV-experienced men, were prescribed ARVs.
This cluster of 9 men with phylogenetically related highly drug-resistant MDR HIV strains and common risk factors but without reported direct epidemiologic links may have important implications to public health. This cluster demonstrates the importance of primary resistance testing and of collaboration between the public and private medical community in identifying MDR outbreaks. Public health interventions and surveillance are needed to reduce transmission of MDR HIV-1. From 2005 through 2007, Seattle health care providers identified cases of primary multiclass drug-resistant (MDR) HIV-1 with common patterns of resistance to antiretrovirals (ARVs). Through surveillance activities and genetic analysis, the local Health Department and the University of Washington identified phylogenetically linked cases among ARV treatment-naive and -experienced individuals. HIV-1 pol nucleotide consensus sequences submitted to the University of Washington Clinical Virology Laboratory were assessed for phylogenetically related MDR HIV. Demographic and clinical data collected included HIV diagnosis date, ARV history, and laboratory results. Seven ARV-naive men had phylogenetically linked MDR strains with resistance to most ARVs; these were linked to 2 ARV-experienced men. All 9 men reported methamphetamine use and multiple anonymous male partners. Primary transmissions were diagnosed for more than a 2-year period, 2005- 2007. Three, including the 2 ARV-experienced men, were prescribed ARVs. This cluster of 9 men with phylogenetically related highly drug-resistant MDR HIV strains and common risk factors but without reported direct epidemiologic links may have important implications to public health. This cluster demonstrates the importance of primary resistance testing and of collaboration between the public and private medical community in identifying MDR outbreaks. Public health interventions and surveillance are needed to reduce transmission of MDR HIV-1. BACKGROUND:From 2005 through 2007, Seattle health care providers identified cases of primary multiclass drug-resistant (MDR) HIV-1 with common patterns of resistance to antiretrovirals (ARVs). Through surveillance activities and genetic analysis, the local Health Department and the University of Washington identified phylogenetically linked cases among ARV treatment-naive and -experienced individuals. METHODS:HIV-1 pol nucleotide consensus sequences submitted to the University of Washington Clinical Virology Laboratory were assessed for phylogenetically related MDR HIV. Demographic and clinical data collected included HIV diagnosis date, ARV history, and laboratory results. RESULTS:Seven ARV-naive men had phylogenetically linked MDR strains with resistance to most ARVs; these were linked to 2 ARV-experienced men. All 9 men reported methamphetamine use and multiple anonymous male partners. Primary transmissions were diagnosed for more than a 2-year period, 2005-2007. Three, including the 2 ARV-experienced men, were prescribed ARVs. CONCLUSIONS:This cluster of 9 men with phylogenetically related highly drug-resistant MDR HIV strains and common risk factors but without reported direct epidemiologic links may have important implications to public health. This cluster demonstrates the importance of primary resistance testing and of collaboration between the public and private medical community in identifying MDR outbreaks. Public health interventions and surveillance are needed to reduce transmission of MDR HIV-1. Background: From 2005 through 2007, Seattle health care providers identified cases of primary multiclass drug-resistant (MDR) HIV-1 with common patterns of resistance to antiretrovirals (ARVs). Through surveillance activities and genetic analysis, the local Health Department and the University of Washington identified phylogenetically linked cases among ARV treatment-naive and -experienced individuals. Methods: HIV-1 pol nucleotide consensus sequences submitted to the University of Washington Clinical Virology Laboratory were assessed for phylogenetically related MDR HIV. Demographic and clinical data collected included HIV diagnosis date, ARV history, and laboratory results. Results: Seven ARV-naive men had phylogenetically linked MDR strains with resistance to most ARVs; these were linked to 2 ARV-experienced men. All 9 men reported methamphetamine use and multiple anonymous male partners. Primary transmissions were diagnosed for more than a 2-year period, 2005-2007. Three, including the 2 ARV-experienced men, were prescribed ARVs. Conclusions: This cluster of 9 men with phylogenetically related highly drug-resistant MDR HIV strains and common risk factors but without reported direct epidemiologic links may have important implications to public health. This cluster demonstrates the importance of primary resistance testing and of collaboration between the public and private medical community in identifying MDR outbreaks. Public health interventions and surveillance are needed to reduce transmission of MDR HIV-1. BACKGROUNDFrom 2005 through 2007, Seattle health care providers identified cases of primary multiclass drug-resistant (MDR) HIV-1 with common patterns of resistance to antiretrovirals (ARVs). Through surveillance activities and genetic analysis, the local Health Department and the University of Washington identified phylogenetically linked cases among ARV treatment-naive and -experienced individuals. METHODSHIV-1 pol nucleotide consensus sequences submitted to the University of Washington Clinical Virology Laboratory were assessed for phylogenetically related MDR HIV. Demographic and clinical data collected included HIV diagnosis date, ARV history, and laboratory results. RESULTSSeven ARV-naive men had phylogenetically linked MDR strains with resistance to most ARVs; these were linked to 2 ARV-experienced men. All 9 men reported methamphetamine use and multiple anonymous male partners. Primary transmissions were diagnosed for more than a 2-year period, 2005-2007. Three, including the 2 ARV-experienced men, were prescribed ARVs. CONCLUSIONSThis cluster of 9 men with phylogenetically related highly drug-resistant MDR HIV strains and common risk factors but without reported direct epidemiologic links may have important implications to public health. This cluster demonstrates the importance of primary resistance testing and of collaboration between the public and private medical community in identifying MDR outbreaks. Public health interventions and surveillance are needed to reduce transmission of MDR HIV-1. |
Author | Buskin, Susan E Schwartz, Margot Pepper, Gregory G Frenkel, Lisa M Horwitch, Carrie Olliffe, Jeffrey F Johnson, Karen Shalit, Peter Wood, Robert W Gottlieb, Geoffrey S Pergam, Steven A Heinen, Corinne Ellis, Giovanina M |
AuthorAffiliation | From the HIV/AIDS Epidemiology Unit, HIV/AIDS Program, Public Health-Seattle & King County, Seattle, WA; †Departments of Epidemiology, Laboratory Medicine, Pediatrics, Allergy and Infectious Diseases, Family Medicine, Medicine, and Health Services, University of Washington, Seattle, WA; ‡Department of Childhood Infection, Seattle Childrenʼs Hospital Research Institute, Seattle, WA; §Virginia Mason Medical Center, Seattle, WA; ‖Country Doctor Community Clinic, Seattle, WA; and ¶Department of HIV Research, Swedish Medical Center, Seattle, WA |
AuthorAffiliation_xml | – name: From the HIV/AIDS Epidemiology Unit, HIV/AIDS Program, Public Health-Seattle & King County, Seattle, WA; †Departments of Epidemiology, Laboratory Medicine, Pediatrics, Allergy and Infectious Diseases, Family Medicine, Medicine, and Health Services, University of Washington, Seattle, WA; ‡Department of Childhood Infection, Seattle Childrenʼs Hospital Research Institute, Seattle, WA; §Virginia Mason Medical Center, Seattle, WA; ‖Country Doctor Community Clinic, Seattle, WA; and ¶Department of HIV Research, Swedish Medical Center, Seattle, WA – name: Department of Childhood Infection, Seattle Children's Hospital Research Institute, Seattle, WA – name: Virginia Mason Medical Center, Seattle, WA – name: Department of HIV Research, Swedish Medical Center, Seattle, WA – name: Departments of Epidemiology, Laboratory Medicine, Pediatrics, Allergy and Infectious Diseases, Family Medicine, Medicine, and Health Services, University of Washington, Seattle, WA – name: HIV/AIDS Epidemiology Unit, HIV/AIDS Program, Public Health–Seattle & King County, Seattle, WA – name: Country Doctor Community Clinic, Seattle, WA |
Author_xml | – sequence: 1 givenname: Susan surname: Buskin middlename: E fullname: Buskin, Susan E organization: From the HIV/AIDS Epidemiology Unit, HIV/AIDS Program, Public Health-Seattle & King County, Seattle, WA; †Departments of Epidemiology, Laboratory Medicine, Pediatrics, Allergy and Infectious Diseases, Family Medicine, Medicine, and Health Services, University of Washington, Seattle, WA; ‡Department of Childhood Infection, Seattle Childrenʼs Hospital Research Institute, Seattle, WA; §Virginia Mason Medical Center, Seattle, WA; ‖Country Doctor Community Clinic, Seattle, WA; and ¶Department of HIV Research, Swedish Medical Center, Seattle, WA – sequence: 2 givenname: Giovanina surname: Ellis middlename: M fullname: Ellis, Giovanina M – sequence: 3 givenname: Gregory surname: Pepper middlename: G fullname: Pepper, Gregory G – sequence: 4 givenname: Lisa surname: Frenkel middlename: M fullname: Frenkel, Lisa M – sequence: 5 givenname: Steven surname: Pergam middlename: A fullname: Pergam, Steven A – sequence: 6 givenname: Geoffrey surname: Gottlieb middlename: S fullname: Gottlieb, Geoffrey S – sequence: 7 givenname: Carrie surname: Horwitch fullname: Horwitch, Carrie – sequence: 8 givenname: Jeffrey surname: Olliffe middlename: F fullname: Olliffe, Jeffrey F – sequence: 9 givenname: Karen surname: Johnson fullname: Johnson, Karen – sequence: 10 givenname: Peter surname: Shalit fullname: Shalit, Peter – sequence: 11 givenname: Corinne surname: Heinen fullname: Heinen, Corinne – sequence: 12 givenname: Margot surname: Schwartz fullname: Schwartz, Margot – sequence: 13 givenname: Robert surname: Wood middlename: W fullname: Wood, Robert W |
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Keywords | multiple drug resistance Homosexuality Microbiology HIV-1 virus Transmission Retroviridae disease clustering Lentivirus Virology HIV HIV-1 Virus Multiple resistance highly active antiretroviral therapy Antiviral Human immunodeficiency virus |
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Snippet | BACKGROUND:From 2005 through 2007, Seattle health care providers identified cases of primary multiclass drug-resistant (MDR) HIV-1 with common patterns of... From 2005 through 2007, Seattle health care providers identified cases of primary multiclass drug-resistant (MDR) HIV-1 with common patterns of resistance to... Background: From 2005 through 2007, Seattle health care providers identified cases of primary multiclass drug-resistant (MDR) HIV-1 with common patterns of... BACKGROUNDFrom 2005 through 2007, Seattle health care providers identified cases of primary multiclass drug-resistant (MDR) HIV-1 with common patterns of... |
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SubjectTerms | AIDS/HIV Anti-HIV Agents - therapeutic use Biological and medical sciences Contact Tracing Disease Outbreaks Disease transmission Drug resistance Drug Resistance, Multiple, Viral Drug therapy Epidemiology Fundamental and applied biological sciences. Psychology Gays & lesbians Genetics HIV HIV Infections - epidemiology HIV Infections - transmission HIV Infections - virology HIV-1 - classification HIV-1 - drug effects HIV-1 - isolation & purification Homosexuality, Male Human immunodeficiency virus Human immunodeficiency virus 1 Human viral diseases Humans Infectious diseases Male Medical sciences Microbiology Miscellaneous Phylogeny pol Gene Products, Human Immunodeficiency Virus - genetics Risk factors RNA, Viral - genetics Sequence Analysis, DNA Sexual Partners Viral diseases Virology Washington - epidemiology |
Title | Transmission Cluster of Multiclass Highly Drug-Resistant HIV-1 Among 9 Men Who Have Sex With Men in Seattle/King County, WA, 2005-2007 |
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