{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:20:00Z","timestamp":1790126400087,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100010877","name":"ViiV Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010877","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Our aim was to determine the prevalence and characteristics of people with HIV on antiretroviral therapy (ART) with multidrug resistance (MDR; confirmed resistance to three or more [or resistance to two or more plus contraindication to one or more] core ART classes) and limited treatment options (LTOs) in Spain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was an observational, retrospective, multicentre, cross\u2010sectional chart review study undertaken in five reference Spanish centres. Participants were people with HIV on ART with MDR and LTOs (detectable viral load [HIV\u2010RNA\u2009&gt;200 copies\/mL], treatment\u2010limiting drug\u2013drug interaction [DDI], or intolerance precluding the use of one or more ART classes). Prevalence, demographic\/clinical characteristics, and treatment options were assessed. Logistic regression analyses were used to identify MDR\u2010associated variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 14\u2009955 screened people with HIV, 69 (0.46%) presented with MDR and 23 (0.15%) had LTOs. The population analysed was 73.9% male with a median age of 54.0\u2009years; the median time since HIV diagnosis was 26.5\u2009years, and median CD4+ cell count was 511.0 cells\/\u03bcL. The only factor significantly associated with MDR (univariate analysis) was CD4+ cell count. Injection drug use was the most common transmission route. Comorbidities (mainly endocrine and cardiovascular disorders; 34.8% affecting HIV management) and concomitant treatments were frequent. No recent opportunistic infections were reported. Patients had been exposed to the following ART: nucleoside analogue reverse transcriptase inhibitors (100%), protease inhibitors (95.6%), non\u2010nucleoside analogue reverse transcriptase inhibitors (87.0%), and integrase strand transfer inhibitors (82.6%). The available fully active drugs were dolutegravir (39.1%), bictegravir (30.4%), and raltegravir (21.7%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The prevalence of people with HIV with MDR and LTOs in Spain is very low, with approximately half of those studied not exhibiting virological suppression. Low CD4+ cell counts were associated with MDR. These findings may help address the impact and treatment needs of these patients and prevent clinical progression and transmission of MDR HIV.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13650","type":"journal-article","created":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T05:49:32Z","timestamp":1714542572000},"page":"946-957","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence of people living with multidrug\u2010resistant HIV and limited treatment options in Spain"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7158-6753","authenticated-orcid":false,"given":"Josep M.","family":"Llibre","sequence":"first","affiliation":[{"name":"Infectious Diseases Service, Hospital Universitari Germans Trias i Pujol  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7611-781X","authenticated-orcid":false,"given":"Federico","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Microbiology Service, Hospital Universitario Cl\u00ednico San Cecilio  Granada Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.Granada)  Granada Spain"},{"name":"CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Blanco","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital Cl\u00ednic de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esmeralda Palmier","family":"Pel\u00e1ez","sequence":"additional","affiliation":[{"name":"Internal Medicine Service, Hospital San Juan De Dios  Le\u00f3n Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1lvaro Mena","family":"de Cea","sequence":"additional","affiliation":[{"name":"Internal Medicine Service\u2013Infectious Diseases Unit\u2010HIV, Hospital Universitario de A Coru\u00f1a  La Coru\u00f1a Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9347-527X","authenticated-orcid":false,"given":"Luis L\u00f3pez","family":"Cort\u00e9s","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital Virgen del Rocio  Sevilla Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta Montero","family":"Alonso","sequence":"additional","affiliation":[{"name":"Internal Medicine Service\u2013Infectious Diseases Unit, Hospital Universitario y Polit\u00e9cnico La Fe  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Pascual","family":"Bern\u00e1ldez","sequence":"additional","affiliation":[{"name":"ViiV Healthcare  Tres Cantos Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Schroeder","sequence":"additional","affiliation":[{"name":"ViiV Healthcare  Brentford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia Esteban","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"ViiV Healthcare  Tres Cantos Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe Rodr\u00edguez","family":"Alc\u00e1ntara","sequence":"additional","affiliation":[{"name":"ViiV Healthcare  Tres Cantos Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,30]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Global HIV & AIDS Statistics\u2013Fact Sheet","author":"UNAIDS","year":"2022"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa880"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200003303421303"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000588"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-024-09122-5"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-020-01379-9"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002679"},{"key":"e_1_2_11_9_1","unstructured":"PatonNM KityoJ CissyM et al.Nucleosides and darunavir\/dolutegravir in Africa (NADIA) trial: 48 wks primary outcome. CROI.2021Abstract number 94; Session number Oral\u201002."},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2246"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2020.1764531"},{"key":"e_1_2_11_12_1","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents.Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. Department of Health and Human Services. Accessed November 17 2023. Available athttps:\/\/clinicalinfo.hiv.gov\/en\/guidelines\/adult-and-adolescent-arv"},{"key":"e_1_2_11_13_1","unstructured":"Unidad de vigilancia del VIH ITS y hepatitis B y C. Actualizaci\u00f3n del Continuo de Atenci\u00f3n del VIH en Espa\u00f1a 2021. Madrid: Centro Nacional de Epidemiolog\u00eda\u2013Instituto de Salud Carlos III\/Divisi\u00f3n de control de VIH ITS Hepatitis Virales y Tuberculosis\u2013Direcci\u00f3n General de Salud P\u00fablica.2023."},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eimc.2011.06.002"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200212060-00023"},{"key":"e_1_2_11_16_1","volume-title":"HIV Drug Resistance Database","author":"Stanford University","year":"2023"},{"key":"e_1_2_11_17_1","unstructured":"Pelchen\u2010MatthewsA Borges\u00c1H ReekieJ et al.Prevalence and outcomes for heavily treatment\u2010experienced (HTE) individuals living with HIV in a European Cohort International AIDS Society meeting.2019TUPEB222."},{"key":"e_1_2_11_18_1","unstructured":"RobineauOA\u2010G CuzinL S\u00e9cherS et al.Prevalence of resistance and limited therapeutic options in patients viremic with ART. Conference on retrovirus and opportunistic infections.2020 pp. 522."},{"key":"e_1_2_11_19_1","volume-title":"Conference on Retroviruses and Opportunistic Infections (CROI)","author":"Zazzi MV","year":"2020"},{"key":"e_1_2_11_20_1","unstructured":"Unidad de Vigilancia de VIH Iyh.Vigilancia Epidemiol\u00f3gica del VIH y sida en Espa\u00f1a 2019: Sistema de Informaci\u00f3n sobre Nuevos Diagn\u00f3sticos de VIH y Registro Nacional de Casos de Sida. Plan Nacional sobre el Sida\u2013DG de Salud P\u00fablica\/Centro Nacional de Epidemiolog\u00eda\u2013ISCIII Madrid.2020."},{"key":"e_1_2_11_21_1","volume-title":"18th European AIDS Conference","author":"Dewandre JV","year":"2021"},{"key":"e_1_2_11_22_1","unstructured":"Centro Nacional de Epidemiolog\u00eda\u2010Instituto de Salud Carlos III\/Plan Nacional sobre el Sida\u2013D.G. de Salud P\u00fablica Calidad e Innovaci\u00f3n. Encuesta Hospitalaria de pacientes con infecci\u00f3n por el VIH. Resultados 2019. An\u00e1lisis de la evoluci\u00f3n 2004\u20102019.2020."},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/v10060293"},{"key":"e_1_2_11_24_1","unstructured":"EACS Guidelines version 12.0 October 2023."},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2017.02323"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1902493"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2115542"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2020.106252"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa456"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.13650","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T04:54:43Z","timestamp":1726635283000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.13650"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,30]]},"references-count":28,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1111\/hiv.13650"],"URL":"https:\/\/doi.org\/10.1111\/hiv.13650","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,30]]},"assertion":[{"value":"2023-11-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}