Transmitted Drug Resistance to Integrase-Based First-Line Human Immunodeficiency Virus Antiretroviral Regimens in Mediterranean Europe.

BACKGROUND

We evaluated the prevalence of transmitted drug resistance (TDR) to integrase strand-transfer inhibitors (INSTIs) and nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) and of clinically relevant resistance (CRR) in newly diagnosed people with human immunodeficiency virus (HIV; PWH) naive to antiretroviral therapy (ART) in Europe.

METHODS

MeditRes is a consortium that includes ART-naive PWH newly diagnosed in France, Greece, Italy, Portugal, and Spain during 2018-2021. Reverse transcriptase and INSTI sequences were provided by participating centers. To evaluate the prevalence of surveillance drug resistance mutations (SDRM), we used the calibrated population resistance tools from the Stanford HIV website. To evaluate CRR, defined as any resistance level ≥3, we used the Stanford HIV Drug Resistance Database v.9.1 algorithm.

RESULTS

We included 2705 PWH, 72% men, median age of 37 years (interquartile range, 30-48); 43.7% were infected by non-B subtypes. The prevalence of INSTI-SDRMs was 0.30% (T66I, T66A, E92Q, E138T, E138K, Y143R, S147G, R263K; all n=1) and the prevalence of NRTI-SDRMs was 5.77% (M184V: 0.85%; M184I: 0.18%; K65R/N: 0.11%; K70E: 0.07%; L74V/I: 0.18%; any thymidine analog mutations: 4.36%). INSTI-CRR was 2.33% (0.15% dolutegravir/bictegravir, 2.29% raltegravir/elvitegravir) and 1.74% to first-line NRTIs (0.89% tenofovir/tenofovir alafenamide, 1.74% abacavir, 1.07% lamivudine/emtricitabine).

CONCLUSIONS

We present the most recent data on TDR to integrase-based first-line regimens in Europe. Given the low prevalence of CRR to second-generation integrase inhibitors and to first-line NRTIs during 2018-2021, it is unlikely that newly diagnosed PWH in MeditRes countries would present with baseline resistance to a first-line regimen based on second-generation integrase inhibitors.

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: [e-mail].

Déclaration de conflit d'intérêts

Potential conflicts of interest. E. T. has received funds for attending meetings and/or travel from Moderna. C. C. has received grants or contracts from ViiV Healthcare, Gilead, and Merck Sharp & Dohme and support for attending meetings and/or travel from Gilead and Merck Sharp & Dohme. A. de M. has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from ViiV Healthcare and Gilead and support for attending meetings and/or travel from ViiV Healthcare. K. S. has received funds for attending symposia, speaking, organizing educational activities, and travel grants from Gilead Sciences and ViiV Healthcare. A. A. has received support and travel support paid to author from Gilead and AbbVie and payment for lectures, presentations, speakers bureaus, manuscript writing, or educational events paid to author from Roche Diagnostics, Vircell, and Gilead. R. D. has received consulting fees for advisory board membership paid to author from GSK, and Hologic and payment or honoraria for lectures from GSK, ViiV Healthcare, Gilead, and Merck Sharp & Dohme. S. L.-N. has received funds for attending symposia, speaking, organizing educational activities, and travel grants from Gilead Sciences, Merck Sharp & Dohme, and ViiV Healthcare. P. G. has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Gilead, Merck Sharp & Dohme, and ViiV Healthcare; support for attending meetings and/or travel from Merck Sharp & Dohme and ViiV Healthcare; and support for participation on a data and safety monitoring board (DSMB) or advisory board from ViiV Healthcare. D. P. has received funds for attending meetings and/or travel from Moderna. M. M. S. has received payment to author for lectures, presentations, speakers bureaus, manuscript writing, or educational events from ViiV Healthcare and for participation on a DSMB or advisory board from ViiV Healthcare, Janssen-Cilag, and Theratechnologies. F. C.-S. has received grants or contracts paid to institution and/or collaborating partner from Gilead Sciences, Merck Sharp & Dohme, and ViiV Healthcare; consulting fees to author from Gilead Sciences, Merck Sharp & Dohme, Theratechnologies, and ViiV Healthcare; and payment or honoraria to author for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie, Gilead Sciences, Janssen-Cilag, Merck Sharp & Dohme, and ViiV Healthcare. A.-G. M. has received support for attending meetings and/or travel from Gilead Sciences and speaking and research grants from ViiV Healthcare, Gilead Sciences, and Merck Sharp & Dohme. F. G. has received grants or contracts from Gilead, AbbVie, Roche, and Seegene; consulting fees from Gilead, ViiV Healthcare, AbbVie, and Thera; payment or honoraria for speaking from Gilead, ViiV Healthcare, AbbVie, Thera, Merck Sharp & Dohme, and Roche; and support for attending symposia from Gilead, AbbVie, and Vircell. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Data availability. Data are available to investigators upon reasonable request.