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

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

Risultato della ricerca: Articlepeer review

12 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 log 10 HIV-1 RNA copies/mL (IQR 4.1–5.3 log 10 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 log 10 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
Stato di pubblicazionePublished - 2018

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)

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