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Updated: Dec 30, 2025
19:57
An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
Published on: March 30, 2014
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HIV MDR is still a relevant issue despite its dramatic drop over the years
D Armenia1,2, D Di Carlo3, P Flandre4
1UniCamillus International University of Health and Medical Sciences, Rome, Italy.
The Journal of Antimicrobial Chemotherapy
|January 25, 2020
Summary
HIV-1 drug resistance in Italy has significantly decreased over two decades. However, multi-drug resistance remains a concern, necessitating careful management for patients on antiretroviral therapy.
Area of Science:
- Virology
- Infectious Diseases
- Public Health
Background:
- Antiretroviral therapy (ART) has transformed HIV-1 management.
- Drug resistance remains a significant challenge in achieving long-term viral suppression.
- Monitoring resistance patterns is crucial for effective HIV-1 treatment strategies.
Purpose of the Study:
- To assess the prevalence and clinical significance of HIV-1 drug resistance in ART-experienced patients in Italy over 20 years (1999-2018).
- To analyze trends in resistance to multiple antiretroviral drug classes.
- To evaluate the impact of drug resistance on virological success after therapy changes.
Main Methods:
- Retrospective analysis of HIV-1 drug resistance mutations in isolates from ART-experienced patients.
- Evaluation of resistance dynamics to one, two, and three or more antiretroviral drug classes.
- Assessment of virological success using genotypic susceptibility scores and Stanford HIV_DB algorithm.
Main Results:
- A sharp decline in resistance to at least one drug class was observed from 1999 to 2010, stabilizing around 40% thereafter.
- Resistance to three or more drug classes remained low (around 5%) but present.
- Integrase inhibitor resistance showed a slight increase after 2008.
- Virological success rates were lower in patients with multi-drug resistance and receiving poorly active regimens.
Conclusions:
- Significant progress has been made in reducing HIV-1 drug resistance in Italy over the past two decades.
- Multi-drug resistance, though low, persists and requires careful diagnostic and therapeutic management.
- Genotype-guided therapy remains essential for optimizing treatment outcomes in drug-resistant HIV-1 infections.
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