Zusammenfassung
HINTERGRUND: Es konnte gezeigt werden, dass Subtypenanalysen und genotypische Resistenzbestimmungen bei HIV-1 infizierten Patienten für epidemiologische und therapeutische Studien sowie für die Impfstoffentwicklung von Bedeutung sind. Die Mehrheit der HIV-1 Isolate kann in Europa dem Subtyp B zugeordnet werden. Durch den Tourismus und die Immigration kommen auch andere Subtypen und rekombinante Virusstämme nach Österreich. ZIEL UND STUDIENDESIGN: Um die Verbreitung der HIV-1 Subtypen zu analysieren, wurden 188 Plasmaproben von behandelten Patienten untersucht. Für die phylogenetischen Analysen wurden die Protease und reverse Transkriptase Region amplifiziert und sequenziert. Anschließend konnten die Subtypen mit einem Sequenzvergleich von Referenzstämmen bestimmt werden. Die genotypischen Resistenzen wurden mit dem Resistenzalgorithmus der Stanford Universität analysiert. ERGEBNISSE: In 20,2% aller Patientenproben konnten andere Stämme als Subtyp B gefunden werden. Mit 50% fand sich der höchste Anteil in den südlichen Bundesländern Österreichs. Mit 85% waren CRF01_AE und CRF02_AG die häufigsten rekombinanten Virusstämme, die in Österreich gefunden wurde. Die Resistenzanalysen zeigten, dass 57,4% aller Patienten keine relevanten Resistenzen für alle drei Virustatikagruppen hatten. Jedoch fanden sich bei 12,2% Multiresistenzen gegen alle Medikamentengruppen. SCHLUSSFOLGERUNG: In weiten Teilen Österreichs kommt der HIV-1 Subtyp B immer noch am häufigsten vor. Dennoch können in den südlichen Bundesländern signifikant mehr "nicht B Subtypen" und rekombinante Virusstämme gefunden werden.
Summary
BACKGROUND: Analysis of HIV-1 subtypes and genotypic resistance have been shown to be relevant for epidemiologic and therapeutic studies or for vaccine development. In Europe, the majority of HIV-1 isolates belong to subtype B. Due to migration an increasing incidence for additional subtypes and complex recombinant forms are expected. OBJECTIVES AND STUDY DESIGN: To evaluate the prevalence of HIV-1 subtypes in Austria, 188 plasma samples of treatment experienced patients were investigated. For phylogenetic analysis protease and reverse transcriptase genes were amplified and sequenced. Subtypes were determined by comparing reference sequences. For genotypic resistance determination, the Resistance-Algorithm-Comparison from Stanford University was used. RESULTS: Non-B subtypes were found in 20.2% of all patients with a dominant prevalence (50%) in the Southern provinces of Austria. With 85% CRF01_AE and CRF02_AG are the predominant circulating recombinant forms in Austria. When resistance mutations were analyzed, 57.4% of all patients were susceptible to all three groups of antiretroviral drugs, whereas in 12.2% resistance against all three classes of antiretroviral drugs was found. CONCLUSION: HIV-1 subtype B is still dominant in major parts of Austria. However, a significantly increasing percentage of non-B subtypes and recombinant forms are observed in the Southern provinces.
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Falkensammer, B., Doerler, M., Kessler, H. et al. Subtype and genotypic resistance analysis of HIV-1 infected patients in Austria. Wien Klin Wochenschr 119, 181–185 (2007). https://doi.org/10.1007/s00508-006-0745-4
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DOI: https://doi.org/10.1007/s00508-006-0745-4