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dc.contributor.authorMonge Corella, Susana 
dc.contributor.authorGuillot, Vicente
dc.contributor.authorAlvarez, Marta
dc.contributor.authorChueca, Natalia
dc.contributor.authorStella, Natalia
dc.contributor.authorPeña, Alejandro
dc.contributor.authorDelgado, Rafael
dc.contributor.authorCórdoba, Juan
dc.contributor.authorAguilera, Antonio
dc.contributor.authorVidal, Carmen
dc.contributor.authorGarcía, Federico
dc.identifier.citationPLoS One . 2014 Mar 17;9(3):e90710.es_ES
dc.description.abstractThe aim was to analyse trends in clinically relevant resistance to first-line antiretroviral drugs in Spain, applying the Stanford algorithm, and to compare these results with reported Transmitted Drug Resistance (TDR) defined by the 2009 update of the WHO SDRM list. We analysed 2781 sequences from ARV naive patients of the CoRIS cohort (Spain) between 2007-2011. Using the Stanford algorithm "Low-level resistance", "Intermediate resistance" and "High-level resistance" categories were considered as "Resistant". 70% of the TDR found using the WHO list were relevant for first-line treatment according to the Stanford algorithm. A total of 188 patients showed clinically relevant resistance to first-line ARVs [6.8% (95%Confidence Interval: 5.8-7.7)], and 221 harbored TDR using the WHO list [7.9% (6.9-9.0)]. Differences were due to a lower prevalence in clinically relevant resistance for NRTIs [2.3% (1.8-2.9) vs. 3.6% (2.9-4.3) by the WHO list] and PIs [0.8% (0.4-1.1) vs. 1.7% (1.2-2.2)], while it was higher for NNRTIs [4.6% (3.8-5.3) vs. 3.7% (3.0-4.7)]. While TDR remained stable throughout the study period, clinically relevant resistance to first line drugs showed a significant trend to a decline (p = 0.02). Prevalence of clinically relevant resistance to first line ARVs in Spain is decreasing, and lower than the one expected looking at TDR using the WHO list. Resistance to first-line PIs falls below 1%, so the recommendation of screening for TDR in the protease gene should be questioned in our setting. Cost-effectiveness studies need to be carried out to inform evidence-based recommendations.es_ES
dc.description.sponsorshipThis work was supported by the Instituto de Salud Carlos III through the Red Temática de Investigación Cooperativa en Sida [ISCIII-RETIC RD06/006 and RD12/0017], and through Grant n° PI12/01053. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.es_ES
dc.publisherPublic Library of Science (PLOS) es_ES
dc.subject.meshDrug Resistance, Viral es_ES
dc.subject.meshAdult es_ES
dc.subject.meshAnti-HIV Agents es_ES
dc.subject.meshCD4 Lymphocyte Count es_ES
dc.subject.meshFemale es_ES
dc.subject.meshHIV Infections es_ES
dc.subject.meshHIV-1 es_ES
dc.subject.meshHumans es_ES
dc.subject.meshMale es_ES
dc.subject.meshMicrobial Sensitivity Tests es_ES
dc.subject.meshMiddle Aged es_ES
dc.subject.meshMutation es_ES
dc.subject.meshProspective Studies es_ES
dc.subject.meshViral Load es_ES
dc.subject.meshYoung Adult es_ES
dc.titleClinically relevant transmitted drug resistance to first line antiretroviral drugs and implications for recommendations.es_ES
dc.typejournal articlees_ES
dc.rights.licenseAtribución 4.0 Internacional*
dc.contributor.funderInstituto de Salud Carlos III 
dc.contributor.funderRed de Investigación Cooperativa en Investigación en Sida (España) 
dc.identifier.journalPloS onees_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemiologíaes_ES
dc.relation.projectIDinfo:eu-repo/grantAgreement/ES/RETIC RD06/006es_ES
dc.rights.accessRightsopen accesses_ES

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