Transmitted drug resistance among HIV-1 drug-naïve patients in Greece

Abstract

Objectives: Despite the success of antiretroviral treatment (ART), the persisting transmitted drug resistance (TDR) and HIV genetic heterogeneity affect the efficacy of treatment. This study explored the prevalence of TDR among ART-naïve HIV patients in Greece during the period 2016-2019. Methods: Genotypic resistance testing was available for 438 ART-naïve HIV patients. Multivariable Poisson regression models were fitted. Results: The majority of patients were male, and there was a slight predominance of Hellenic (26.5%) over non-Hellenic (21.9%) nationality. The prevalence of TDR was 7.8%. There was a predominance of mutations for non-nucleoside reverse-transcriptase inhibitors (5.7%) over nucleoside reversetranscriptase inhibitors (0.2%). No mutations to protease inhibitors were detected. The prevalence of resistance was 22.1% based on all mutations identified through the HIVdb interpretation system. The most frequent resistance sites were E138A (9.6%), K103N (6.4%), and K101E (2.1%). The majority of detected mutations were confined to subtype A (52.6%), followed by B (19.6%). Non-Hellenic nationality was significantly associated with an increased risk of TDR (relative risk 1.32, 95% confidence interval 1.04-1.69). Conclusions: Non-B HIV infections predominate in Greece, with an increasing trend in recent years. The prevalence of TDR remains stable. Ongoing surveillance of resistance testing is needed to secure the longterm success of ART.

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

“…To our knowledge, this is the most updated study showing transmitted resistance to ARV in Spain 14–22 . SDRM detection, in our study, was in line with recent studies published worldwide 18,23–26 with ours again being one of the studies presenting data from a most recent calendar period.…”

Epidemiology of HIV drug resistance in low- and middle-income countries and WHO global strategy to monitor its emergence

“…Although the current WHO survey methodology is not designed to distinguish between PDR and TDR and incidence test are seldomly used in HIVDR prevalence studies or surveys, some studies reported an initial rise in TDR especially to NNRTI which declined possibly due to policy changes involving transition to well-tolerated and high genetic barrier drugs such as DTG-based ART [13][14][15][16][17][18]. On the other hand, the prevalence of TDR to INSTIs is still very low [18,19 & ,20-22].…”

“…). The proportion of countries meeting the target of having at least 5% of patients on secondline ART increased from 45% (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) in 2017 to 56% (14 of 25) in 2020. Overall, most countries reported sub-optimal performance in preventing HIVDR, indicating the need to strengthen the quality and monitoring systems and implement sustainable solutions.…”

Transmitted drug resistance and transmission clusters among HIV-1 treatment-naïve patients in Guangdong, China: a cross-sectional study

“…Transmitted drug resistance (TDR) of HIV is prevalent but varies worldwide. For example, the prevalence of TDR of HIV has been reported to be 4.1% in south/southeast Asia and 6.0% in sub-Saharan Africa [ 6 ] 14% in southwestern Siberia [ 7 ], 7.8% in Greece [ 8 ], 8.0% in Brighton [ 9 ], and 13.1% in Portugal [ 10 ]. In 2015, a nationwide cross-sectional survey revealed that the overall prevalence of TDR was 3.6% in China [ 11 ].…”