Evolution of transmitted HIV-1 drug resistance and viral subtypes circulation in Italy from 2006 to 2016

Simona Di Giambenedetto, Barbara Rossetti, Manuela Colafigli, Andrea De Luca, Francesca Lombardi, Valeria Ghisetti, B. Rossetti, C. Torti, M. C. Postorino, G. Punzi, F. Saladini, W. Gennari, V. Borghi, L. Monno, A. R. Pignataro, E. Polilli, A. Poggi, S. Tini, M. Zazzi, A. De LucaVincenzo Mellace, Amedeo Capetti, Maria Rita Gismondo, Maria Luisa Biondi, Cristina Mussini, Monica Pecorari, Nicola Gianotti, Daria Sacchini, Giustino Parruti, Franco Baldelli, Stefania Zanussi, Alessandro Nerli, Lucia Lenzi, Carlo Calzetti, Angela Vivarelli, Renato Maserati, Fausto Baldanti, Federica Poletti, Vincenzo Mondino, Marina Malena, Antonio Cascio, Gaetano Filice, Giacomo Magnani, Alessandro Zerbini, Simona Di Gaimbenedetto, Massimo Andreoni, Marco Montano, Vincenzo Vullo, Ombretta Turriziani, Angela Gonnelli, Enzo Boeri, Stefano Bonora, Daniela Francisci, Paolo Grossi, Patrizia Bagnarelli, Luca Butini, Romana Del Gobbo, Andrea Giacometti, Danilo Tacconi, Annapaola Callegaro, Franco Maggiolo, Alessia Zoncada, Elisabetta Paolini, Laura Sighinolfi, Grazia Colao, Paola Corsi, Pierluigi Blanc, Luisa Galli, Paola Meraviglia, Andrea Tosti, Bianca Bruzzone, Maurizio Setti, Giovanni Penco, Antonio Di Biagio, Cesira Nencioni, Riccardo Pardelli, Irene Arcidiacono, Alberto Degiuli, Michele De Gennaro, Alessandro Soria, Alfredo Foc, Surace Latella, Lucio Cosco, Sergio Malandrin, Paola Milini, Paola Cicconi, Stefano Rusconi, Valeria Micheli

Risultato della ricerca: Contributo in rivistaArticolo in rivista

15 Citazioni (Scopus)

Abstract

Objectives: The aim was to evaluate the evolution of transmitted HIV-1 drug resistance (TDR) prevalence in antiretroviral therapy (ART)-naïve patients from 2006 to 2016. Methods: HIV-1 sequences were retrieved from the Antiviral Response Cohort Analysis (ARCA) database and TDR was defined as detection of at least one mutation from the World Health Organization (WHO) surveillance list. Results: We included protease/reverse transcriptase sequences from 3573 patients; 455 had also integrase sequences. Overall, 68.1% of the patients were Italian, the median CD4 count was 348 cells/μL [interquartile range (IQR) 169–521 cells/μL], and the median viral load was 4.7 log10 HIV-1 RNA copies/mL (IQR 4.1–5.3 log10 copies/mL). TDR was detected in 10.3% of patients: 6% carried mutations to nucleos(t)ide reverse transcriptase inhibitors (NRTIs), 4.4% to nonnucleos(t)ide reverse transcriptase inhibitors (NNRTIs), 2.3% to protease inhibitors (PIs), 0.2% to integrase strand transfer inhibitors (INSTIs) and 2.1% to at least two drug classes. TDR declined from 14.5% in 2006 to 7.3% in 2016 (P = 0.003): TDR to NRTIs from 9.9 to 2.9% (P = 0.003) and TDR to NNRTIs from 5.1 to 3.7% (P = 0.028); PI TDR remained stable. The proportion carrying subtype B virus declined from 76.5 to 50% (P < 0.001). The prevalence of TDR was higher in subtype B vs. non-B (12.6 vs. 4.9%, respectively; P < 0.001) and declined significantly in subtype B (from 17.1 to 8.8%; P = 0.04) but not in non-B subtypes (from 6.1 to 5.8%; P = 0.44). Adjusting for country of origin, predictors of TDR were subtype B [adjusted odds ratio (AOR) for subtype B vs. non-B 2.91; 95% confidence interval (CI) 1.93–4.39; P < 0.001], lower viral load (per log10 higher: AOR 0.86; 95% CI 0.75–0.99; P = 0.03), site in northern Italy (AOR for southern Italy/island vs. northern Italy, 0.61; 95% CI 0.40–0.91; P = 0.01), and earlier calendar year (per 1 year more recent: AOR 0.95; 95% CI 0.91–0.99; P = 0.02). Conclusions: The prevalence of HIV-1 TDR has declined during the last 10 years in Italy.
Lingua originaleEnglish
pagine (da-a)619-628
Numero di pagine10
RivistaHIV Medicine
Volume19
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • HIV
  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)
  • antiretroviral therapy
  • recent HIV infection
  • resistance epidemiology
  • transmitted HIV drug resistance

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