Sociodemographic, Ecological, and Spatiotemporal Factors Associated with Human Immunodeficiency Virus Drug Resistance in Florida: A Retrospective Analysis.
Anti-HIV Agents
/ therapeutic use
DNA-Directed RNA Polymerases
Drug Resistance, Viral
Florida
/ epidemiology
HIV Infections
/ drug therapy
HIV-1
/ drug effects
Humans
Infectious Disease Transmission, Vertical
Mutation
Nucleosides
/ therapeutic use
Retrospective Studies
Reverse Transcriptase Inhibitors
/ therapeutic use
Sociodemographic Factors
Spatio-Temporal Analysis
Antiretroviral therapy
HIV drug resistance
HIV in the South
Journal
The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675
Informations de publication
Date de publication:
03 03 2021
03 03 2021
Historique:
received:
27
03
2020
accepted:
06
07
2020
pubmed:
10
7
2020
medline:
2
2
2022
entrez:
10
7
2020
Statut:
ppublish
Résumé
Persons living with human immunodeficiency virus (HIV) with resistance to antiretroviral therapy are vulnerable to adverse HIV-related health outcomes and can contribute to transmission of HIV drug resistance (HIVDR) when nonvirally suppressed. The degree to which HIVDR contributes to disease burden in Florida-the US state with the highest HIV incidence- is unknown. We explored sociodemographic, ecological, and spatiotemporal associations of HIVDR. HIV-1 sequences (n = 34 447) collected during 2012-2017 were obtained from the Florida Department of Health. HIVDR was categorized by resistance class, including resistance to nucleoside reverse-transcriptase , nonnucleoside reverse-transcriptase , protease , and integrase inhibitors. Multidrug resistance and transmitted drug resistance were also evaluated. Multivariable fixed-effects logistic regression models were fitted to associate individual- and county-level sociodemographic and ecological health indicators with HIVDR. The HIVDR prevalence was 19.2% (nucleoside reverse-transcriptase inhibitor resistance), 29.7% (nonnucleoside reverse-transcriptase inhibitor resistance), 6.6% (protease inhibitor resistance), 23.5% (transmitted drug resistance), 13.2% (multidrug resistance), and 8.2% (integrase strand transfer inhibitor resistance), with significant variation by Florida county. Individuals who were older, black, or acquired HIV through mother-to-child transmission had significantly higher odds of HIVDR. HIVDR was linked to counties with lower socioeconomic status, higher rates of unemployment, and poor mental health. Our findings indicate that HIVDR prevalence is higher in Florida than aggregate North American estimates with significant geographic and socioecological heterogeneity.
Sections du résumé
BACKGROUND
Persons living with human immunodeficiency virus (HIV) with resistance to antiretroviral therapy are vulnerable to adverse HIV-related health outcomes and can contribute to transmission of HIV drug resistance (HIVDR) when nonvirally suppressed. The degree to which HIVDR contributes to disease burden in Florida-the US state with the highest HIV incidence- is unknown.
METHODS
We explored sociodemographic, ecological, and spatiotemporal associations of HIVDR. HIV-1 sequences (n = 34 447) collected during 2012-2017 were obtained from the Florida Department of Health. HIVDR was categorized by resistance class, including resistance to nucleoside reverse-transcriptase , nonnucleoside reverse-transcriptase , protease , and integrase inhibitors. Multidrug resistance and transmitted drug resistance were also evaluated. Multivariable fixed-effects logistic regression models were fitted to associate individual- and county-level sociodemographic and ecological health indicators with HIVDR.
RESULTS
The HIVDR prevalence was 19.2% (nucleoside reverse-transcriptase inhibitor resistance), 29.7% (nonnucleoside reverse-transcriptase inhibitor resistance), 6.6% (protease inhibitor resistance), 23.5% (transmitted drug resistance), 13.2% (multidrug resistance), and 8.2% (integrase strand transfer inhibitor resistance), with significant variation by Florida county. Individuals who were older, black, or acquired HIV through mother-to-child transmission had significantly higher odds of HIVDR. HIVDR was linked to counties with lower socioeconomic status, higher rates of unemployment, and poor mental health.
CONCLUSIONS
Our findings indicate that HIVDR prevalence is higher in Florida than aggregate North American estimates with significant geographic and socioecological heterogeneity.
Identifiants
pubmed: 32644119
pii: 5869388
doi: 10.1093/infdis/jiaa413
pmc: PMC7938178
doi:
Substances chimiques
Anti-HIV Agents
0
Nucleosides
0
Reverse Transcriptase Inhibitors
0
DNA-Directed RNA Polymerases
EC 2.7.7.6
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
866-875Subventions
Organisme : NIAID NIH HHS
ID : R01 AI145552
Pays : United States
Organisme : NIAID NIH HHS
ID : R21 AI138815
Pays : United States
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
Références
AIDS Patient Care STDS. 2017 Apr;31(4):167-175
pubmed: 28414260
J Rural Health. 2013 Jun;29(3):266-80
pubmed: 23802929
Antivir Ther. 2012;17(2):377-86
pubmed: 22297391
Open Forum Infect Dis. 2018 Jul 20;5(8):ofy178
pubmed: 30151407
Clin Infect Dis. 2015 May 15;60(10):1541-9
pubmed: 25681380
J Infect Dis. 2017 May 1;215(9):1362-1365
pubmed: 28329236
Infect Genet Evol. 2016 Dec;46:292-307
pubmed: 27587334
Nucleic Acids Res. 2014 Oct;42(18):e144
pubmed: 25120265
Harm Reduct J. 2019 Jan 23;16(1):7
pubmed: 30674334
PeerJ. 2018 May 25;6:e4848
pubmed: 29844989
Clin Infect Dis. 2016 Mar 1;62(5):640-7
pubmed: 26553011
AIDS Res Hum Retroviruses. 2018 Aug;34(8):672-679
pubmed: 29732898
Clin Infect Dis. 2016 Sep 15;63(6):836-843
pubmed: 27307507
PLoS One. 2009;4(3):e4724
pubmed: 19266092
J Acquir Immune Defic Syndr. 2016 Feb 1;71(2):228-36
pubmed: 26413846
Popul Health Metr. 2015 Apr 17;13:11
pubmed: 25931988
Lancet Infect Dis. 2012 Apr;12(4):307-17
pubmed: 22036233