Patterns of Transmitted Drug Resistance Mutations and HIV-1 Subtype Dynamics in ART-Naïve Individuals in Veneto, Italy, from 2017 to 2024
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View abstract on PubMed
Summary
This summary is machine-generated.Transmitted drug resistance mutations (TDRMs) in HIV-1 are a persistent challenge, with increasing resistance to newer drugs like integrase inhibitors observed in Italy. Continuous surveillance is vital for adapting antiretroviral therapy (ART) regimens.
Area Of Science
- * Virology and Epidemiology
- * Infectious Diseases
- * Public Health
Background
- * Antiretroviral therapy (ART) has transformed HIV management, but transmitted drug resistance mutations (TDRMs) pose a significant challenge to treatment efficacy.
- * Understanding the prevalence and patterns of TDRMs and HIV-1 subtypes is crucial for guiding public health interventions and optimizing ART strategies.
- * Surveillance of drug resistance in antiretroviral therapy (ART)-naïve populations provides essential insights into the evolving landscape of HIV-1 genetic diversity and treatment challenges.
Purpose Of The Study
- * To investigate the prevalence and patterns of transmitted drug resistance mutations (TDRMs) and HIV-1 subtypes in ART-naïve individuals in Veneto, Italy.
- * To analyze trends in HIV-1 subtypes and TDRMs from 2017 to 2024 to inform effective treatment strategies.
- * To assess the emergence of resistance against newer antiretroviral drug classes.
Main Methods
- * Retrospective analysis of genotypic resistance testing data from 762 ART-naïve people with HIV (PWH) in Veneto, Italy (2017-2024).
- * Utilized the Stanford HIVdb algorithm for predicting drug susceptibility and determining HIV-1 subtype distribution.
- * Categorized participants into Italian and foreign groups to analyze subtype prevalence.
Main Results
- * A slight, statistically significant decline in the B subtype among Italian PWH (p=0.045) was observed, with a non-significant increase in non-B subtypes among foreign individuals (p=0.333).
- * Non-nucleoside Reverse Transcriptase Inhibitor (NNRTI) resistance was most frequent, particularly in non-B subtypes, rising from 10.7% (2017-2019) to 15.5% (2020-2024).
- * Consistent detection of TDRMs was noted, alongside a concerning increase in mutations against integrase inhibitors, indicating evolving resistance patterns.
Conclusions
- * Ongoing surveillance of HIV-1 subtypes and TDRMs is essential for adapting ART regimens and optimizing clinical outcomes.
- * The emergence of resistance to newer drug classes, such as integrase inhibitors, necessitates continuous vigilance and potential adjustments in treatment protocols.
- * Despite stable overall drug resistance levels, the changing patterns of resistance highlight the dynamic nature of HIV-1 and the need for proactive management strategies.
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