Applying Next-Generation Sequencing to Track HIV-1 Drug Resistance Mutations Circulating in Portugal.
Viruses
; 16(4)2024 04 17.
Article
in En
| MEDLINE
| ID: mdl-38675962
ABSTRACT
BACKGROUND:
The global scale-up of antiretroviral treatment (ART) offers significant health benefits by suppressing HIV-1 replication and increasing CD4 cell counts. However, incomplete viral suppression poses a potential threat for the emergence of drug resistance mutations (DRMs), limiting ART options, and increasing HIV transmission.OBJECTIVE:
We investigated the patterns of transmitted drug resistance (TDR) and acquired drug resistance (ADR) among HIV-1 patients in Portugal.METHODS:
Data were obtained from 1050 HIV-1 patient samples submitted for HIV drug resistance (HIVDR) testing from January 2022 to June 2023. Evaluation of DRM affecting viral susceptibility to nucleoside/tide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and integrase strand transfer inhibitors (INSTIs) was performed using an NGS technology, the Vela Diagnostics Sentosa SQ HIV-1 Genotyping Assay.RESULTS:
About 71% of patients were ART naïve and 29% were experienced. Overall, 20% presented with any DRM. The prevalence of TDR and ADR was 12.6% and 41.1%, respectively. M184V, T215S, and M41L mutations for NRTI, K103N for NNRTI, and M46I/L for PIs were frequent in naïve and treated patients. E138K and R263K mutations against INSTIs were more frequent in naïve than treated patients. TDR and ADR to INSTIs were 0.3% and 7%, respectively. Patients aged 50 or over (OR 1.81, p = 0.015), originating from Portuguese-speaking African countries (PALOPs) (OR 1.55, p = 0.050), HIV-1 subtype G (OR 1.78, p = 0.010), and with CD4 < 200 cells/mm3 (OR 1.70, p = 0.043) were more likely to present with DRMs, while the males (OR 0.63, p = 0.003) with a viral load between 4.1 to 5.0 Log10 (OR 0.55, p = 0.003) or greater than 5.0 Log10 (OR 0.52, p < 0.001), had lower chances of presenting with DRMs.CONCLUSIONS:
We present the first evidence on TDR and ADR to INSTI regimens in followed up patients presenting for healthcare in Portugal. We observed low levels of TDR to INSTIs among ART-naïve and moderate levels in ART-exposed patients. Regimens containing PIs could be an alternative second line in patients with intermediate or high-level drug resistance, especially against second-generation INSTIs (dolutegravir, bictegravir, and cabotegravir).Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
HIV Infections
/
HIV-1
/
Anti-HIV Agents
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Drug Resistance, Viral
/
High-Throughput Nucleotide Sequencing
/
Mutation
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Viruses
Year:
2024
Document type:
Article