Transmitted Drug Resistance among HIV-1 drug-naïve patients in Greece.

Abstract

OBJECTIVES\nDespite the success of antiretroviral treatment (ART), the persisting transmitted drug resistance (TDR) and HIV genetic heterogeneity affect treatment efficacy. We explored the prevalence of TDR among ART-naïve HIV patients in Greece during the period 2016-2019.\n\n\nMETHODS\nGenotypic resistance testing was available for 438 ART-naïve HIV patients. Multivariable Poisson regressions were fitted.\n\n\nRESULTS\nThe majority of patients were males with a slight predominance of Hellenic (26.5%) over non-Hellenic (21.9%) nationality. The prevalence of TDR was 7.8% with a predominance of mutations for non-nucleoside reverse-transcriptase inhibitors (5.7%) over nucleoside reverse-transcriptase inhibitors (0.2%). No mutations to protease inhibitors were detected. The resistance prevalence was 22.1% based on all mutations identified through the HIVdb interpretation system. The most frequent resistant 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 statistically significantly associated with increased risk for TDR (relative risk: 1.32, 95% confidence intervals: 1.04-1.69).\n\n\nCONCLUSIONS\nNon-B HIV infections predominate in Greece with an increasing trend in recent years. The prevalence of TDR remains stable. The ongoing surveillance of resistance testing is needed to secure the long-term success of ART.