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Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
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Integrase Strand Transfer Inhibitors (INSTIs) Resistance Mutations in HIV-1 Infected Turkish Patients.

M Sayan1,2, A Gündüz3, G Ersöz4

  • 1a Faculty of Medicine, Clinical Laboratory, PCR Unit , University of Kocaeli , Kocaeli , Turkey.

HIV Clinical Trials
|April 30, 2016
PubMed
Summary

Integrase strand transfer inhibitor (INSTI) resistance mutations were not found in newly diagnosed HIV patients in Turkey. However, 6.6% of experienced patients showed INSTI resistance, highlighting the need for resistance testing in HIV management.

Keywords:
DNA sequencingDolutegravirDrug resistanceElvitegravirHIV-1 integraseIntegrase inhibitorsRaltegravir

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Area of Science:

  • Virology
  • Infectious Diseases
  • Pharmacology

Background:

  • Integrase strand transfer inhibitors (INSTIs) are a crucial class of antiretroviral drugs for HIV-1 treatment.
  • INSTIs function by inhibiting the viral integrase enzyme, preventing HIV-1 genome integration into host DNA.
  • Understanding INSTI resistance is vital for effective long-term HIV management.

Purpose of the Study:

  • To investigate the prevalence of INSTI resistance mutations in HIV-1-infected patients in Turkey.
  • To assess INSTI resistance in both antiretroviral (ARV) naive and experienced patient cohorts.
  • To provide data guiding HIV treatment strategies involving INSTIs.

Main Methods:

  • A cross-sectional study conducted in Turkey from April 2013 to April 2015.
  • Inclusion of 169 HIV-1-infected patients: 78 ARV naive and 91 ARV experienced.
  • Population-based sequencing of HIV-1 pol gene domains (reverse transcriptase, protease, integrase) to detect resistance mutations.

Main Results:

  • No INSTI resistance mutations were detected in ARV naive patients.
  • Among ARV-experienced patients, 6.6% (6/91) exhibited major INSTI resistance mutations (F121Y, Y143R, Q148R, E157Q).
  • These mutations are associated with resistance to raltegravir and elvitegravir.

Conclusions:

  • The presence of INSTI resistance mutations in experienced patients underscores treatment challenges.
  • Routine HIV drug resistance testing should be integrated into clinical management for patients on INSTI therapy.
  • This study provides the first data on INSTI resistance in Turkish HIV patients.