Factors in transmission

Published: 07 April 2009

A study of 21 recently infected injecting drug users and 56 individuals who contracted HIV through sexual activity found no difference in the rate of transmission, suggesting no difference in the transmissibility of drug-resistant viruses by blood or by sexual intercourse.1

Sexually transmitted infections have been found to significantly increase the risk of drug-resistant HIV transmission.2 In gay men, crystal methamphetamine use has been linked to the transmission of NNRTI-resistant virus.3

As discussed above, prevalence of transmitted resistance varies according to the class of drug. In chronically infected, untreated people, NRTI resistance remains the most prevalent form of resistance.4

Data from the United States showed that the proportion of people contracting PI-resistant virus rose from less than 1% between 1996 and 1998 to 8% between 1999 and 2000.5

Transmission of NNRTI-resistant virus is becoming more common in the United States. Rates of NNRTI-resistant virus were about 1% between 1996 and 1998 and rose to 7% between 1999 and 2000.5 A study of 225 people with recent HIV infection who presented to the San Francisco General Hospital between June 1996 and June 2001 found that the overall prevalence of resistant strains in 2000 to 2001 was 27%, similar to the 25% prevalence found in 1996 and 1997. However, while the prevalence of PI- and NRTI-resistant virus remained fairly stable over time, the prevalence of NNRTI-related resistance rose from 0 to 13% over the same period, and resistance to two drug classes increased concomitantly.6

References

  1. Salomon H et al. Prevalence of HIV-1 resistant to antiretroviral drugs in 81 individuals newly infected by sexual contact or injecting drug use. Investigators of the Quebec Primary Infection Study. AIDS 14: F17-F23, 2000
  2. Nambiar K et al. Acquisition of transmitted drug resistant HIV-1 infection is associated with the presence of sexually transmitted infections. Fourteenth Conference on Retroviruses and Opportunistic Infections, Los Angeles, abstract 657, 2007
  3. Nash Colfax G et al. Frequent methamphetamine use is associated with primary non-nucleoside reverse transcriptase inhibitor resistance. AIDS 21: 239-240, 2007
  4. Novak RM et al. Prevalence of antiretroviral drug resistance mutations in chronically HIV-infected, treatment-naive patients: implications for routine resistance screening before initiation of antiretroviral therapy. Clin Infect Dis 40: 468-474, 2005
  5. Little S et al. Antiretroviral-drug resistance among patients recently infected with HIV. N Engl J Med 347: 385-394, 2002
  6. Grant RM et al. Transmission of drug resistant HIV-1 exhibiting lower replication capacity is associated with higher CD4 cell counts. Antivir Ther 7: S41, 2002
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.