Background: The transmission of HIV-1 drug-resistant strains in drug naive patients may seriously compromise the efficacy of a first-line antiretroviral treatment. To better define this problem, a study in a cohort of newly diagnosed HIV-1 infected individuals has been conducted. This study is aimed to assess the prevalence and the patterns of the mutations recently associated with transmitted drug resistance in the reverse transcriptase (RT) and in protease (PR) of HIV-1. Methods: Prevalence of transmitted drug resistant strains is determined in 255 newly diagnosed HIV-1 infected patients enrolled in different counselling and testing (CT) centres in Central Italy; the Avidity Index (AI) on the first available serum sample is also used to estimate time since infection. Logistic regression models are used to determine factors associated with infection by drug resistant HIV-1 strains. Results: The prevalence of HIV-1 strains with at least one major drug resistance mutation is 5.9% (15/255); moreover, 3.9% (10/255) of patients is infected with HIV nucleoside reverse transcriptase inhibitor (NRTI)-resistant viruses, 3.5% (9/255) with HIV non-NRTI-resistant viruses and 0.4% (1/255) with HIV protease inhibitor (PI)-resistant viruses. Most importantly, almost half (60.0%) of patients carries HIV-1 resistant strains with more than one major drug resistance mutation. In addition, patients who had acquired HIV through homosexual intercourses are more likely to harbour a virus with at least one primary resistance mutation (OR 7.7; 95% CI: 1.7-35.0, P = 0.008). Conclusion: The prevalence of drug resistant HIV-1 strains among newly diagnosed individuals in Central Italy is consistent with the data from other European countries. Nevertheless, the presence of drug-resistance HIV-1 mutations in complex patterns highlights an additional potential risk for public health and strongly supports the extension of wide genotyping to newly diagnosed HIV-1 infected patients.

Alteri, C., Svicher, V., Gori, C., D'Arrigo, R., Ciccozzi, M., CECCHERINI SILBERSTEIN, F., et al. (2009). Characterization of the patterns of drug-resistance mutations in newly diagnosed HIV-1 infected patients naive to the antiretroviral drugs. BMC INFECTIOUS DISEASES, 9, 111 [10.1186/1471-2334-9-111].

Characterization of the patterns of drug-resistance mutations in newly diagnosed HIV-1 infected patients naive to the antiretroviral drugs

Svicher, V;CECCHERINI SILBERSTEIN, FRANCESCA;PERNO, CARLO FEDERICO;SARMATI, LOREDANA;
2009

Abstract

Background: The transmission of HIV-1 drug-resistant strains in drug naive patients may seriously compromise the efficacy of a first-line antiretroviral treatment. To better define this problem, a study in a cohort of newly diagnosed HIV-1 infected individuals has been conducted. This study is aimed to assess the prevalence and the patterns of the mutations recently associated with transmitted drug resistance in the reverse transcriptase (RT) and in protease (PR) of HIV-1. Methods: Prevalence of transmitted drug resistant strains is determined in 255 newly diagnosed HIV-1 infected patients enrolled in different counselling and testing (CT) centres in Central Italy; the Avidity Index (AI) on the first available serum sample is also used to estimate time since infection. Logistic regression models are used to determine factors associated with infection by drug resistant HIV-1 strains. Results: The prevalence of HIV-1 strains with at least one major drug resistance mutation is 5.9% (15/255); moreover, 3.9% (10/255) of patients is infected with HIV nucleoside reverse transcriptase inhibitor (NRTI)-resistant viruses, 3.5% (9/255) with HIV non-NRTI-resistant viruses and 0.4% (1/255) with HIV protease inhibitor (PI)-resistant viruses. Most importantly, almost half (60.0%) of patients carries HIV-1 resistant strains with more than one major drug resistance mutation. In addition, patients who had acquired HIV through homosexual intercourses are more likely to harbour a virus with at least one primary resistance mutation (OR 7.7; 95% CI: 1.7-35.0, P = 0.008). Conclusion: The prevalence of drug resistant HIV-1 strains among newly diagnosed individuals in Central Italy is consistent with the data from other European countries. Nevertheless, the presence of drug-resistance HIV-1 mutations in complex patterns highlights an additional potential risk for public health and strongly supports the extension of wide genotyping to newly diagnosed HIV-1 infected patients.
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/17 - Malattie Infettive
English
Con Impact Factor ISI
proteinase; proteinase inhibitor; RNA directed DNA polymerase; RNA directed DNA polymerase inhibitor; Human immunodeficiency virus antibody; virus RNA; adult; antiviral resistance; article; binding affinity; codon; DNA polymorphism; female; genotype; homosexuality; human; Human immunodeficiency virus 1 infection; Italy; major clinical study; male; phylogeny; prevalence; virus carrier; virus load; virus mutation; virus resistance; virus strain; blood; cohort analysis; drug effect; genetics; Human immunodeficiency virus 1; Human immunodeficiency virus infection; middle aged; molecular evolution; mutation; sequence alignment; statistical model; Adult; Cohort Studies; Drug Resistance, Viral; Evolution, Molecular; Female; HIV Antibodies; HIV Infections; HIV Protease Inhibitors; HIV-1; Humans; Italy; Logistic Models; Male; Middle Aged; Mutation; Phylogeny; Prevalence; Reverse Transcriptase Inhibitors; RNA, Viral; Sequence Alignment
Alteri, C., Svicher, V., Gori, C., D'Arrigo, R., Ciccozzi, M., CECCHERINI SILBERSTEIN, F., et al. (2009). Characterization of the patterns of drug-resistance mutations in newly diagnosed HIV-1 infected patients naive to the antiretroviral drugs. BMC INFECTIOUS DISEASES, 9, 111 [10.1186/1471-2334-9-111].
Alteri, C; Svicher, V; Gori, C; D'Arrigo, R; Ciccozzi, M; CECCHERINI SILBERSTEIN, F; Selleri, M; Bardacci, S; Giuliani, M; Elia, P; Scognamiglio, P; Balzano, R; Orchi, N; Girardi, E; Perno, Cf; Capobianchi, M; De Carli, G; Galati, V; Grisetti, S; Navarra, A; Nicastri, E; Pittalis, S; Puro, V; Sampaolesi, A; Nurra, G; Selleri, M; Zaccarelli, M; Zaniratti, M; Di Carlo, A; Giuliani, M; De Filippis, A; Brancatella, R; Maggi, T; Gattari, P; Spizzichino, L; Schito, S; Sarmati, L; Battagin, G; Tacconi, L; Gallo, I; Anzalone, E; Pitorri, A; Caterini, A; Barbacci, S
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/39199
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