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- Title
HIV-1 integrase genotyping is reliable and reproducible for routine clinical detection of integrase resistance mutations even in patients with low-level viraemia.
- Authors
Armenia, D.; Fabeni, L.; Alteri, C.; Pinto, D. Di; Carlo, D. Di; Bertoli, A.; Gori, C.; Carta, S.; Fedele, V.; Forbici, F.; D'Arrigo, R.; Svicher, V.; Berno, G.; Pizzi, D.; Nicastri, E.; Sarmati, L.; Pinnetti, C.; Ammassari, A.; D'Offizi, G.; Latini, A.
- Abstract
Objectives: Integrase drug resistance monitoring deserves attention because of the increasing number of patients being treated with integrase strand-transfer inhibitors. Therefore, we evaluated the integrase genotyping success rate at low-level viraemia (LLV, 51-1000 copies/mL) and resistance in raltegravir-failing patients. Methods: An integrase genotypic resistance test (GRT) was performed on 1734 HIV-1 samples collected during 2006-13. Genotyping success rate was determined according to the following viraemia levels: 51-500, 501-1000, 1001-10000, 10001-100000 and .100000 copies/mL. The reproducibility of integrase GRT was evaluated in 41 plasma samples processed in duplicate in two reference centres. The relationship between LLV and resistance prevalence was evaluated in a subset of 120 raltegravir-failing patients. Results: Overall, the integrase genotyping success rate was 95.7%. For viraemia levels 51-500 and 501-1000 copies/mL, the rate of success was 82.1% and 94.0%, respectively. GRT was reproducible, producing sequences with a high similarity and an equal resistance profile regardless of the sequencing centre or viraemia level. Resistance was detected both at LLV and at viraemia .1000 copies/mL (51-500 copies/mL=18.2%; 501-1000=37.5%; 1001-10000=53.7%; 10001-100000=30.0%; and .100000=30.8%). At viraemia ⩽500 copies/mL, Q148H/K/R and N155H had the same prevalence (9.1%), while the Y143C/H/R was completely absent. At early genotyping (within 3 months of raltegravir treatment), Q148H/K/R and N155H mutations were detected regardless of the viraemia level, while Y143C/H/R was observed only in samples with viraemia .1000 copies/mL. Conclusions: Our findings prove the reliability of HIV-1 integrase genotyping and reinforce the concept that this assay may be useful in the management of failures even at LLV.
- Subjects
INTEGRASES; VIREMIA; RALTEGRAVIR; DRUG resistance in microorganisms; HIV-positive persons
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2015, Vol 70, Issue 6, p1865
- ISSN
0305-7453
- Publication type
Article
- DOI
10.1093/jac/dkv029