Primary resistance to integrase strand transfer inhibitors in Spain using ultrasensitive HIV-1 genotyping
Por:
Casadella, M, Santos, JR, Noguera-Julian, M, Mican-Rivera, R, Domingo, P, Antela, A, Portilla, J, Sanz, J, Montero-Alonso, M, Navarro, J, Masia, M, Valcarce-Pardeiro, N, Ocampo, A, Perez-Martinez, L, Pasquau, J, Vivancos, MJ, Imaz, A, Carmona-Oyaga, P, Munoz-Medina, L, Villar-Garcia, J, Barrufet, P and Paredes, R
Publicada:
1 dic 2020
Resumen:
Background: Transmission of resistance mutations to integrase strand transfer inhibitors (INSTIs) in HIV-infected patients may compromise the efficacy of first-Line antiretroviral regimens currently recommended worldwide. Continued surveillance of transmitted drug resistance (TDR) is thus warranted.
Objectives: We evaluated the rates and effects on virological outcomes of TDR in a 96 week prospective multicentre cohort study of ART-naive HIV-1-infected subjects initiating INSTI-based ART in Spain between April 2015 and December 2016.
Methods: Pre-ART plasma samples were genotyped for integrase, protease and reverse transcriptase resistance using Sanger population sequencing or MiSeq (TM) using a >= 20% mutant sensitivity cut-off. Those present at 1%-19% of the virus population were considered to be Low-frequency variants.
Results: From a total of 214 available samples, 173 (80.8%), 210 (98.1%) and 214 (100.0%) were successfully amplified for integrase, reverse transcriptase and protease genes, respectively. Using a Sanger-Like cut-off, the overall prevalence of any TDR, INSTI-, NRTI-, NNRTI- and protease inhibitor (PI)-associated mutations was 13.1%, 1.7%, 3.8%, 7.1% and 0.9%, respectively. Only three (1.7%) subjects had INSTI TDR (R263K, E138K and G163R), while minority variants with integrase TDR were detected in 9.6% of subjects. There were no virological failures during 96 weeks of follow-up in subjects harbouring TDR as majority variants.
Conclusions: Transmitted INSTI resistance remains rare in Spain and, to date, is not associated with virological failure to first-Line INSTI-based regimens.
Filiaciones:
:
IrsiCaixa AIDS Res Inst, Badalona, Catalonia, Spain
:
Lluita SIDA Fdn, Hosp Univ Germans Trias & Pujol, Badalona, Spain
:
IrsiCaixa AIDS Res Inst, Badalona, Catalonia, Spain
Mican-Rivera, R:
Univ Hosp La Paz, Madrid, Spain
Domingo, P:
Hosp Santa Creu & Sant Pau, Infect Dis Unit, Barcelona, Spain
Antela, A:
Santiago de Compostela Clin Univ Hosp, Infect Dis Unit, Santiago De Compostela, Spain
Portilla, J:
Hosp Gen Univ Alicante, Alicante, Spain
Sanz, J:
Univ Hosp La Princesa, Madrid, Spain
Montero-Alonso, M:
La Fe Univ & Polytech Hosp, Infect Dis Unit, Valencia, Spain
Navarro, J:
Hosp Univ Vall dHebron, Infect Dis Dept, Barcelona, Spain
Masia, M:
Elche Univ, Gen Hosp, Infect Dis Unit, Elche, Spain
Valcarce-Pardeiro, N:
Hosp Arquitecto Marcide, Infect Dis Unit, Ferrol, Spain
Ocampo, A:
Hosp Alvaro Cunqueiro, HIV Unit, Vigo, Spain
Perez-Martinez, L:
Hosp San Pedro CIBIR, Infect Dis Area, Logrono, Spain
Pasquau, J:
Univ Hosp Virgen de las Nieves, Granada, Spain
Vivancos, MJ:
Ramon & Cajal Hosp, Infect Dis Unit, Madrid, Spain
Imaz, A:
Bellvitge Univ Hosp, HIV & STI Unit, Bellvitge Biomed Res Inst IDIBELL, Infect Dis Dept, Lhospitalet De Llobregat, Spain
Carmona-Oyaga, P:
Donostia Univ Hosp, Infect Dis Unit, San Sebastian, Spain
Munoz-Medina, L:
Univ Hosp San Cecilio, Granada, Spain
Villar-Garcia, J:
Hosp del Mar IMIM, Infect Dis Dept, Barcelona, Spain
Barrufet, P:
Mataro Hosp, Infect Dis Unit, Mataro, Spain
:
IrsiCaixa AIDS Res Inst, Badalona, Catalonia, Spain
Lluita SIDA Fdn, Hosp Univ Germans Trias & Pujol, Badalona, Spain
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