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JAC Advance Access published online on August 22, 2007
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkm274
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Trends of prevalence of primary HIV drug resistance in Germany

Abdurrahman Sagir1, Mark Oette1,*, Rolf Kaiser2, Martin Däumer2, Gerd Fätkenheuer3, Jürgen Kurt Rockstroh4, Heribert Knechten5, Günther Schmutz6, Martin Hower7, Jetske Emmelkamp1, Herbert Pfister2, Dieter Häussinger on behalf of the RESINA Study Team1

1 Clinic for Gastroenterology, Hepatology, and Infectious Diseases, University Clinic Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany 2 Institute of Virology, University of Köln, Fürst-Pückler-Str. 56, 50935 Köln, Germany 3 Clinic I for Internal Medicine, University of Köln, Kerpenerstr. 62, 50937 Köln, Germany 4 Clinic for Internal Medicine, University of Bonn, Sigmund-Freund-Str. 25, 53127 Bonn, Germany 5 Private Practice, Blondelstr. 9, 52062 Aachen, Germany 6 Private Practice, Grafenberger Allee 128, 40237 Düsseldorf, Germany 7 Klinikum Dortmund Nord, Münsterstr. 240, 44145 Dormund, Germany

Received 16 February 2007; returned 19 June 2007; accepted 3 July 2007

* Corresponding author. Tel: +49-211/81-18942; Fax: +49-211/81-16294; E-mail: oettem{at}med.uni-duesseldorf.de

Background: Primary HIV drug resistance (PDR) is associated with poor treatment outcome of first-line highly active antiretroviral therapy (HAART). The aim of the study was to observe the trend of prevalence of PDR between 2001 and 2005.

Methods: In a prospective multicentre study in the state of Nordrhein-Westfalen, Germany, 831 treatment-naive chronically HIV-infected patients underwent genotypic resistance testing.

Results: Six hundred and forty (77%) of them were male. Two-thirds of the patients (558, 67%) were infected with HIV subtype B. PDR was found in 75 of 831 [9%; 95% confidence interval (CI) 7.1–10.9] cases entering the study between January 2001 and December 2005. An increasing trend of PDR was found from 2001 (4.8%; CI 2.1–9.4) to 2005 (9.0%; CI 5.4–12.6; P = 0.08). A significant tendency to higher PDR was observed for ethnicity other than Caucasian (P = 0.04), HIV subtypes other than B (P = 0.02) and transmission routes other than homosexual (P = 0.03).

Conclusions: A non-significant increase in prevalence of PDR was observed from 2001 to 2005. A significant trend to higher PDR rate was detected in non-Caucasian patients, patients infected with non-B subtypes, and in patients with risk factors for acquisition of HIV other than homosexual transmission. Based on the fact that there is a trend to higher PDR rate, resistance testing in untreated HIV-infected patients starting HAART becomes more important in clinical routine. The identification of patient subgroups with a remarkable risk of PDR makes continuous monitoring of PDR mandatory.

Key Words: epidemiology , HAART , RESINA


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