Molecular and epidemiological characterization of HIV-1 infection networks involving transmitted drug resistance mutations in Northern Greece

Lemonia Skoura*, Simeon Metallidis, Andrew J. Buckton, Jean L. Mbisa, Dimitrios Pilalas, Evagelia Papadimitriou, Androniki Papoutsi, Anna Bettina Haidich, Theofilos Chrysanthidis, Olga Tsachouridou, Zoe A. Antoniadou, Panagiotis Kollaras, Pavlos Nikolaidis, Nikolaos Malisiovas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


Objectives: To determine the contribution of transmission clusters to transmitted drug resistance (TDR) in newly diagnosed antiretroviral-naive HIV-1-infected patients in Northern Greece during 2000-07. Methods: The prevalence of TDR was estimated in 369 individuals who were diagnosed with HIV-1 infection in the period 2000-07 at the National AIDS Reference Laboratory of Northern Greece. Phylogenetic analysis was performed using a maximum likelihood method on partial pol sequences. TDR was defined in accordance with the surveillance drug resistance mutation list (2009 update). Results: The overall prevalence of TDR in our population was 12.5% [46/369, 95% confidence interval (CI) 9.1%-15.8%], comprising 7.6% (28/369) resistant to nucleoside reverse transcriptase inhibitors, 5.4% (20/369) resistant to non-nucleoside reverse transcriptase inhibitors and 3.3% (12/369) resistant to protease inhibitors. Dual class resistance was identified in 3.8% (14/369). Infection with subtype A was the sole predictor associated with TDR in multivariate analysis (odds ratio 2.15, 95% CI 1.10-4.19, P=0.025). Phylogenetic analyses revealed three statistically robust transmission clusters involving drug-resistant strains, including one cluster of 12 patients, 10 of whom were infected with a strain carrying both T215 revertants and Y181C mutations. Conclusions: Our findings underline the substantial impact of transmission networks on TDR in our population.

Original languageEnglish
Article numberdkr386
Pages (from-to)2831-2837
Number of pages7
JournalJournal of Antimicrobial Chemotherapy
Issue number12
Publication statusPublished - Dec 2011

Bibliographical note

Funding Information:
This work was supported by a grant (81227) from the Hellenic Centre for Disease Control and Prevention. L. S. was supported by a scholarship from the Hellenic Association for the Study and Control of AIDS.


  • Molecular epidemiology
  • Resistance


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