Transmitted drug resistance to antiretroviral drugs in Spain during the period 2019–2021

To evaluate the prevalence of transmitted drug resistance (TDR) to nucleoside and nonnucleoside reverse transcriptase inhibitors (NRTI, NNRTI), protease inhibitors (PI), and integrase strand transfer inhibitors (INSTI) in Spain during the period 2019–2021, as well as to evaluate transmitted clinical...

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Published in:Journal of medical virology 2023-12, Vol.95 (12), p.e29287-n/a
Main Authors: Viñuela, Laura, Salazar, Adolfo, Fuentes, Ana, Serrano‐Conde, Esther, Falces‐Romero, Iker, Pinto, Adriana, Portilla, Irene, Masiá, Mar, Peraire, Joaquim, Gómez‐Sirvent, Juan Luis, Sanchiz, Marta, Iborra, Asunción, Baza, Begoña, Aguilera, Antonio, Olalla, Julián, Espinosa, Nuria, Iribarren, José Antonio, Martínez‐Velasco, Marina, Imaz, Arkaitz, Montero, Marta, Rivero, María, Suarez‐García, Inés, Maciá, María Dolores, Galán, Juan Carlos, Perez‐Elias, Maria Jesus, García‐Fraile, Lucio Jesús, Moreno, Cristina, Garcia, Federico
Format: Article
Language:English
Subjects:
Algorithms
Anti-HIV Agents - pharmacology
Anti-HIV Agents - therapeutic use
Anti-Retroviral Agents - pharmacology
Anti-Retroviral Agents - therapeutic use
Antiretroviral agents
Antiretroviral drugs
Antiretroviral therapy
clinical resistance
Drug resistance
Drug Resistance, Viral - genetics
Drugs
HIV
HIV Infections - drug therapy
HIV Infections - epidemiology
Human immunodeficiency virus
Humans
Integrase
Integrases - genetics
Integrases - therapeutic use
Mutation
Non-nucleoside reverse transcriptase inhibitors
Phylogeny
Prevalence
Protease
Protease inhibitors
Proteinase inhibitors
Reverse Transcriptase Inhibitors - pharmacology
Reverse Transcriptase Inhibitors - therapeutic use
RNA-directed DNA polymerase
Spain - epidemiology
Surveillance
TDR
transmission
Virology
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Summary:To evaluate the prevalence of transmitted drug resistance (TDR) to nucleoside and nonnucleoside reverse transcriptase inhibitors (NRTI, NNRTI), protease inhibitors (PI), and integrase strand transfer inhibitors (INSTI) in Spain during the period 2019–2021, as well as to evaluate transmitted clinically relevant resistance (TCRR) to antiretroviral drugs. Reverse transcriptase (RT), protease (Pro), and Integrase (IN) sequences from 1824 PLWH (people living with HIV) were studied. To evaluate TDR we investigated the prevalence of surveillance drug resistance mutations (SDRM). To evaluate TCRR (any resistance level ≥ 3), and for HIV subtyping we used the Stanford v.9.4.1 HIVDB Algorithm and an in‐depth phylogenetic analysis. The prevalence of NRTI SDRMs was 3.8% (95% CI, 2.8%–4.6%), 6.1% (95% CI, 5.0%–7.3%) for NNRTI, 0.9% (95% CI, 0.5%–1.4%) for PI, and 0.2% (95% CI, 0.0%–0.9%) for INSTI. The prevalence of TCRR to NRTI was 2.1% (95% CI, 1.5%–2.9%), 11.8% for NNRTI, (95% CI, 10.3%–13.5%), 0.2% (95% CI, 0.1%–0.6%) for PI, and 2.5% (95% CI, 1.5%–4.1%) for INSTI. Most of the patients were infected by subtype B (79.8%), while the majority of non‐Bs were CRF02_AG (n = 109, 6%). The prevalence of INSTI and PI resistance in Spain during the period 2019–2021 is low, while NRTI resistance is moderate, and NNRTI resistance is the highest. Our results support the use of integrase inhibitors as first‐line treatment in Spain. Our findings highlight the importance of ongoing surveillance of TDR to antiretroviral drugs in PLWH particularly with regard to first‐line antiretroviral therapy.
ISSN:0146-6615
1096-9071
DOI:10.1002/jmv.29287