HIV-1 transmitted drug resistance in newly diagnosed individuals in Italy over the period 2015-21.

Journal

The Journal of antimicrobial chemotherapy

ISSN: 1460-2091

Titre abrégé: J Antimicrob Chemother

Pays: England

ID NLM: 7513617

Informations de publication

Date de publication:
19 Jul 2024

Historique:

received: 10 04 2024

accepted: 22 05 2024

medline: 19 7 2024

pubmed: 19 7 2024

entrez: 19 7 2024

Statut: aheadofprint

Résumé

Transmitted drug resistance (TDR) is still a critical aspect for the management of individuals living with HIV-1. Thus, its evaluation is crucial to optimize HIV care. Overall, 2386 HIV-1 protease/reverse transcriptase and 1831 integrase sequences from drug-naïve individuals diagnosed in north and central Italy between 2015 and 2021 were analysed. TDR was evaluated over time. Phylogeny was generated by maximum likelihood. Factors associated with TDR were evaluated by logistic regression. Individuals were mainly male (79.1%) and Italian (56.2%), with a median (IQR) age of 38 (30-48). Non-B infected individuals accounted for 44.6% (N = 1065) of the overall population and increased over time (2015-2021, from 42.1% to 51.0%, P = 0.002). TDR prevalence to any class was 8.0% (B subtype 9.5% versus non-B subtypes 6.1%, P = 0.002) and remained almost constant over time. Overall, 300 transmission clusters (TCs) involving 1155 (48.4%) individuals were identified, with a similar proportion in B and non-infected individuals (49.7% versus 46.8%, P = 0.148). A similar prevalence of TDR among individuals in TCs and those out of TCs was found (8.2% versus 7.8%, P = 0.707).By multivariable analysis, subtypes A, F, and CFR02_AG were negatively associated with TDR. No other factors, including being part of TCs, were significantly associated with TDR. Between 2015 and 2021, TDR prevalence in Italy was 8% and remained almost stable over time. Resistant strains were found circulating regardless of being in TCs, but less likely in non-B subtypes. These results highlight the importance of a continuous surveillance of newly diagnosed individuals for evidence of TDR to inform clinical practice.

Sections du résumé

BACKGROUND BACKGROUND

Transmitted drug resistance (TDR) is still a critical aspect for the management of individuals living with HIV-1. Thus, its evaluation is crucial to optimize HIV care.

METHODS METHODS

Overall, 2386 HIV-1 protease/reverse transcriptase and 1831 integrase sequences from drug-naïve individuals diagnosed in north and central Italy between 2015 and 2021 were analysed. TDR was evaluated over time. Phylogeny was generated by maximum likelihood. Factors associated with TDR were evaluated by logistic regression.

RESULTS RESULTS

Individuals were mainly male (79.1%) and Italian (56.2%), with a median (IQR) age of 38 (30-48). Non-B infected individuals accounted for 44.6% (N = 1065) of the overall population and increased over time (2015-2021, from 42.1% to 51.0%, P = 0.002). TDR prevalence to any class was 8.0% (B subtype 9.5% versus non-B subtypes 6.1%, P = 0.002) and remained almost constant over time. Overall, 300 transmission clusters (TCs) involving 1155 (48.4%) individuals were identified, with a similar proportion in B and non-infected individuals (49.7% versus 46.8%, P = 0.148). A similar prevalence of TDR among individuals in TCs and those out of TCs was found (8.2% versus 7.8%, P = 0.707).By multivariable analysis, subtypes A, F, and CFR02_AG were negatively associated with TDR. No other factors, including being part of TCs, were significantly associated with TDR.

CONCLUSIONS CONCLUSIONS

Between 2015 and 2021, TDR prevalence in Italy was 8% and remained almost stable over time. Resistant strains were found circulating regardless of being in TCs, but less likely in non-B subtypes. These results highlight the importance of a continuous surveillance of newly diagnosed individuals for evidence of TDR to inform clinical practice.

Identifiants

DOI: 10.1093/jac/dkae189 PMID: 39028674

pubmed: 39028674

pii: 7717140

doi: 10.1093/jac/dkae189

pii:

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Subventions

Organisme : Fondazione Aviralia

Investigateurs

F Ceccherini-Silberstein (F)

M C Bellocchi (MC)

L Carioti (L)

M M Santoro (MM)

M Andreoni (M)

M Iannetta (M)

A Bertoli (A)

L Sarmati (L)

V Malagnino (V)

E Teti (E)

D Armenia (D)

A Antinori (A)

F Baldini (F)

R Bellagamba (R)

G Berno (G)

M Camici (M)

S Cicalini (S)

F De Zottis (F)

R Esvan (R)

L Fabeni (L)

F Forbici (F)

M Fusto (M)

R Gagliardini (R)

S Gebremeskel (S)

F Gili (F)

E Girardi (E)

E Grilli (E)

S Grisetti (S)

I Mastrorosa (I)

V Mazzotta (V)

A Mondi (A)

N Orchi (N)

S Ottou (S)

C Pinnetti (C)

S Pittalis (S)

D Pizzi (D)

M Plazzi (M)

A Vergori (A)

A R Buonomini (AR)

M Giuliani (M)

A Latini (A)

A Pacifici (A)

C F Perno (CF)

V Belvisi (V)

C Del Borgo (C)

A Carraro (A)

M Lichtner (M)

R Marocco (R)

V Borghi (V)

C Mussini (C)

W Gennari (W)