Work

High levels of transmitted drug resistance to INSTIs and NNRTIs in Chile: A nationwide prevalence study

Year: 2025

Type: article

Abstract: BACKGROUND: Human Immunodeficiency Virus (HIV) morbi-mortality and transmission have decreased due to antiretroviral therapy (ART). However, treatment failure still occurs when acquiring a strain with resistance mutations. HIV transmitted drug resistance (TDR) is increasing worldwide, and its prevalence in Chile was estimated at 10.4 % in 2018. We aimed to determine the prevalence of TDR and, its associated mutations to evaluate the need to incorporate genotyping studies in ART-naïve people living with HIV in Chile. METHODS: Cross-sectional study conducted in eleven health centers and seven regions in Chile. Participants were ≥ 18 years with a recent (≤12 months) HIV diagnosis, without previous ART exposure. Genotyping of the reverse transcriptase, protease, and integrase was performed using nested polymerase chain reaction followed by Sanger sequencing. RESULTS: Between February 2023 and May 2024, 168 participants were recruited. The mean age was 35.9 years (range 18-78), 89.3 % were Chilean, and 84.5 % were male. TDR overall prevalence was 16.7 %, and the percentage of TDR by family was 3 % for nucleoside reverse transcriptase inhibitors (NRTIs), 7.1 % for non-nucleoside reverse transcriptase inhibitors (NNRTIs), 0.6 % for protease inhibitors (PIs) and 8.9 % for integrase strand transfer inhibitors (INSTIs). TDR for first-generation INSTIs was 11.9 % and 1.2 % for second-generation INSTIs. CONCLUSION: TDR prevalence in Chile has increased and main affected families are first-generation INSTIs and NNRTIs. This result highlights the relevance of initiating ART with second-generation INSTIs or PIs, or incorporating baseline genotyping studies when initiating ART with NNRTIs or first-generation INSTIs.

Source: Journal of Clinical Virology

DOI: 10.1016/j.jcv.2025.105890