Trends in drug resistance-associated mutations in a real-life cohort of Italian patients infected with HIV-1

• Published in: Journal of global antimicrobial resistance. 2015-12, Vol.3 (4), p.267-272
• Main Authors: Montagna, Claudia, Mazzuti, Laura, Falasca, Francesca, Maida, Paola, Bucci, Mauro, D’Ettorre, Gabriella, Mezzaroma, Ivano, Fantauzzi, Alessandra, Alvaro, Nadia, Vullo, Vincenzo, Antonelli, Guido, Turriziani, Ombretta
• Format: Article
• Language: English
• Subjects: Drug resistance; Genotype resistance test; HIV-1
• ISSN: 2213-7165; 2213-7173
• DOI: 10.1016/j.jgar.2015.07.006

•A decline in the frequency of HIV resistance mutations to old drug classes was observed.•The levels of HIV RNA have been decreasing over time.•An increase in N155H mutation was documented. Recent studies support the idea that human immunodeficiency virus type 1 (HIV-1) drug resistance is declining in developed countries. To help assess the current situation in Italy, the dynamics of drug resistance mutations in pol and integrase genes in plasma samples from HIV-1-positive patients attending Sapienza University Hospital, Rome, from 2003 to 2014 were analysed. In total, 1730 genotype resistance tests (GRTs) were retrospectively analysed. The prevalence of major drug resistance mutations (DRMs) was evaluated over time in the global population and in patients with antiretroviral therapy (ART) failure. Population dynamics, changes in ART administration, and HIV-1 RNA levels were analysed in combination with DRM trends. The global population showed a strong reduction in major DRMs to all drug classes. Over the 2003–2014 decade, resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs) declined from 80.0% to 18.7%, from 42.8% to 20.1% and from 74.2% to 8.3%, respectively (P