Emergence of acquired HIV-1 drug resistance has almost been stopped in Switzerland – a 15 year prospective cohort analysis. Clinical Infectious Diseases
Scherrer et al. aimed to study the trends of HIV-1 drug resistance prevalence in the Swiss HIV Cohort Study during 15 years in antiretroviral treatment (ART)-experienced individuals. Overall, 28.9% of ART-experienced patients were ever detected with a drug resistance mutation. This proportion was highest in patients who started ART before 1999 (56.2%) and declined to 19.7% and 9.7% among patients who started ART in 1999-2006 or 2007–2013, respectively. The prevalence of 3-class resistance decreased from 9.0% to 4.4% and was always <0.4% for patients who initiated ART after 2006. Most patients actively participating in the SHCS in 2013 with drug-resistant viruses initiated ART before 1999 (59.8%).
In conclusion, the study demonstrates that the emergence of HIV-1 drug resistance has been dramatically reduced with the introduction of new drugs and modern treatment strategies, particularly in the period after 2007. New emergence of 3-class resistance on ART is almost nonexistent.