Evolution of transmitted HIV‐1 drug resistance and viral subtypes circulation in Italy from 2006 to 2016. Issue 9 (22nd June 2018)

• Record Type: Journal Article
• Authors: Rossetti, B; Di Giambenedetto, S; Torti, C; Postorino, MC; Punzi, G; Saladini, F; Gennari, W; Borghi, V; Monno, L; Pignataro, AR; Polilli, E; Colafigli, M; Poggi, A; Tini, S; Zazzi, M; De Luca, A
• Other Names: Mellace Vincenzo investigator.; Capetti Amedeo investigator.; Gismondo Maria Rita investigator.; Biondi Maria Luisa investigator.; Mussini Cristina investigator.; Pecorari Monica investigator.; Gianotti Nicola investigator.; Sacchini Daria investigator.; Parruti Giustino investigator.; Baldelli Franco investigator.; Zanussi Stefania investigator.; Nerli Alessandro investigator.; Lenzi Lucia investigator.; Calzetti Carlo investigator.; Vivarelli Angela investigator.; Maserati Renato investigator.; Baldanti Fausto investigator.; Poletti Federica investigator.; Mondino Vincenzo investigator.; Malena Marina investigator.; Cascio Antonio investigator.; Filice Gaetano investigator.; Magnani Giacomo investigator.; Zerbini Alessandro investigator.; Lombardi Francesca investigator.; Di Gaimbenedetto Simona investigator.; Andreoni Massimo investigator.; Montano Marco investigator.; Vullo Vincenzo investigator.; Turriziani Ombretta investigator.; Gonnelli Angela investigator.; Boeri Enzo investigator.; Bonora Stefano investigator.; Ghisetti Valeria investigator.; Francisci Daniela investigator.; Grossi Paolo investigator.; Bagnarelli Patrizia investigator.; Butini Luca investigator.; del Gobbo Romana investigator.; Giacometti Andrea investigator.; Tacconi Danilo investigator.; Callegaro Annapaola investigator.; Maggiolo Franco investigator.; Zoncada Alessia investigator.; Paolini Elisabetta investigator.; Sighinolfi Laura investigator.; Colao Grazia investigator.; Corsi Paola investigator.; Blanc Pierluigi investigator.; Galli Luisa investigator.; Meraviglia Paola investigator.; Tosti Andrea investigator.; Bruzzone Bianca investigator.; Setti Maurizio investigator.; Penco Giovanni investigator.; Di Biagio Antonio investigator.; Nencioni Cesira investigator.; Pardelli Riccardo investigator.; Arcidiacono Irene investigator.; Degiuli Alberto investigator.; De Gennaro Michele investigator.; Soria Alessandro investigator.; Foc Alfredo investigator.; Latella Surace investigator.; Cosco Lucio investigator.; Malandrin Sergio investigator.; Milini Paola investigator.; Cicconi Paola investigator.; Rusconi Stefano investigator.; Micheli Valeria investigator.;
• Is Part Of: HIV medicine. Volume 19:Issue 9(2018)
• Page Start: 619
• Page End: 628
• Publication Date: 2018-06-22
• Subjects: antiretroviral therapy -- HIV -- recent HIV infection -- resistance epidemiology -- transmitted HIV drug resistance; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12640
• Languages: English
• ISSNs: 1464-2662

Abstract

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.