Study: Rates of individual HIV mutations, clinically relevant transmitted drug resistance low
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Rates of both individual mutations and clinically relevant transmitted drug resistance were low among people newly diagnosed with HIV who were not previously on ART, according to a recent study.
“There is a lack of updated info on transmitted drug resistance in Europe — and in the rest of the world — and there is an interest on knowing how transmitted drug resistance (TDR) may impact the use of first-line regimens to treat HIV infection, specifically if the prevalence of TDR may justify a need to wait for a resistance test before first line treatment,” Federico García, PharmD, PhD, vice president of the Spanish Society of Infectious Diseases and Clinical Microbiology, told Healio.
García and colleagues used data from MeditRes HIV — a consortium that includes ART-naive people with HIV who have been newly diagnosed in France, Greece, Italy, Portugal and Spain between 2018 and 2021. According to the study, the researchers assessed reverse transcriptase and integrase (INSTI) sequences provided by participating centers to evaluate the prevalence of surveillance drug resistance mutations (SDRMs) and clinically relevant resistance (CRR).
Overall, 2,705 people with HIV were included in the analysis. The researchers found that the prevalence of INSTI-SDRMs was 0.3%, whereas the prevalence of nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)-SDRMs was 5.77%. According to the study, INSTI-CRR was 2.33% (0.15% dolutegravir/bictegravir, 2.29% raltegravir/elvitegravir), and 1.74% to first line NRTIs (0.89% tenofovir/tenofovir alafenamide fumarate, 1.74% abacavir, 1.07% lamivudine/emtricitabine).
Based on these findings, the authors concluded that it is unlikely that people newly diagnosed with HIV in MeditRes countries would present with baseline resistance to a first-line regimen based on second-generation integrase inhibitors.
“Despite the generalized use of integrase inhibitors, TDR to second-generation integrase is very rare,” García said. “Second-generation-based first-line regimens may be started without having to wait for the results of the resistance test.”
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