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Article

Patterns of Transmitted Drug Resistance Mutations and HIV-1 Subtype Dynamics in ART-Naïve Individuals in Veneto, Italy, from 2017 to 2024

by
Nicholas Geremia
1,2,†,
Monica Basso
3,†,
Andrea De Vito
4,5,*,
Renzo Scaggiante
6,
Mario Giobbia
7,
Giuliana Battagin
8,
Federico Dal Bello
3,
Maria Teresa Giordani
9,
Stefano Nardi
10,
Marina Malena
11,
Annamaria Cattelan
3 and
Saverio Giuseppe Parisi
3
1
Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale Dell’Angelo, 30174 Venice, Italy
2
Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale Civile “S.S. Giovanni e Paolo”, 30122 Venice, Italy
3
Department of Molecular Medicine, University of Padua, 35121 Padua, Italy
4
Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
5
Biomedical Science Department, School in Biomedical Science, University of Sassari, 07100 Sassari, Italy
6
Unit of Infectious Diseases, AULSS 1, 32100 Belluno, Italy
7
Unit of Infectious Diseases, AULSS 2, 35100 Treviso, Italy
8
Unit of Infectious Diseases, AULSS 8, 36100 Vicenza, Italy
9
Unit of Infectious Diseases, AULSS 7, 36014 Santorso, Italy
10
Unit of Infectious Diseases, AULSS 9, 37122 Verona, Italy
11
Unit of Infectious Diseases, AULSS 5, 45100 Rovigo, Italy
 
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*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Viruses 2024, 16(9), 1393; https://doi.org/10.3390/v16091393
Submission received: 11 July 2024 / Revised: 10 August 2024 / Accepted: 29 August 2024 / Published: 30 August 2024
(This article belongs to the Special Issue Viral Resistance)
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Abstract

This study investigates the prevalence and patterns of transmitted drug resistance mutations (TDRMs) and HIV-1 subtypes among antiretroviral therapy (ART) naïve individuals in Veneto, Italy, from 2017 to 2024. This research aims to understand the dynamic landscape of TDRMs and HIV-1 genetic diversity to inform treatment strategies effectively. We included all adult ART-naïve people with HIV (PWH) from seven infectious disease units in Veneto, Italy. We collected the genotypic resistance testing conducted to predict drug susceptibility and subtype distribution using the Stanford HIVdb algorithm. We included 762 PWH, showing a slight but statistically significant decline in the B subtype among Italian PWH (p = 0.045) and an increase in non-B subtypes among foreigners, though it was not statistically significant (p = 0.333). The most frequent mutations were in Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs), especially in non-B subtypes, with a notable rise from 10.7% in 2017–2019 to 15.5% in 2020–2024. Notably, TDRMs were consistently detected, highlighting an ongoing challenge despite the stable prevalence observed over the years. In addition, the data revealed a concerning rise in mutations against newer drug classes, such as integrase inhibitors. Conclusively, the study underscores the necessity of continuous surveillance of HIV subtypes and resistance patterns to adapt ART regimens optimally. Despite the stable levels of drug resistance, the emergence of resistance against newer drugs necessitates ongoing vigilance and possible adjustment in treatment protocols to enhance clinical outcomes and manage HIV drug resistance effectively.
Keywords: HIV; genotypic resistance testing; transmitted drug resistance mutations; HIV subtypes; HIV resistance HIV; genotypic resistance testing; transmitted drug resistance mutations; HIV subtypes; HIV resistance

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MDPI and ACS Style

Geremia, N.; Basso, M.; De Vito, A.; Scaggiante, R.; Giobbia, M.; Battagin, G.; Dal Bello, F.; Giordani, M.T.; Nardi, S.; Malena, M.; et al. Patterns of Transmitted Drug Resistance Mutations and HIV-1 Subtype Dynamics in ART-Naïve Individuals in Veneto, Italy, from 2017 to 2024. Viruses 2024, 16, 1393. https://doi.org/10.3390/v16091393

AMA Style

Geremia N, Basso M, De Vito A, Scaggiante R, Giobbia M, Battagin G, Dal Bello F, Giordani MT, Nardi S, Malena M, et al. Patterns of Transmitted Drug Resistance Mutations and HIV-1 Subtype Dynamics in ART-Naïve Individuals in Veneto, Italy, from 2017 to 2024. Viruses. 2024; 16(9):1393. https://doi.org/10.3390/v16091393

Chicago/Turabian Style

Geremia, Nicholas, Monica Basso, Andrea De Vito, Renzo Scaggiante, Mario Giobbia, Giuliana Battagin, Federico Dal Bello, Maria Teresa Giordani, Stefano Nardi, Marina Malena, and et al. 2024. "Patterns of Transmitted Drug Resistance Mutations and HIV-1 Subtype Dynamics in ART-Naïve Individuals in Veneto, Italy, from 2017 to 2024" Viruses 16, no. 9: 1393. https://doi.org/10.3390/v16091393

APA Style

Geremia, N., Basso, M., De Vito, A., Scaggiante, R., Giobbia, M., Battagin, G., Dal Bello, F., Giordani, M. T., Nardi, S., Malena, M., Cattelan, A., & Parisi, S. G. (2024). Patterns of Transmitted Drug Resistance Mutations and HIV-1 Subtype Dynamics in ART-Naïve Individuals in Veneto, Italy, from 2017 to 2024. Viruses, 16(9), 1393. https://doi.org/10.3390/v16091393

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