Surveillance of transmitted drug resistance to integrase inhibitors in Spain: implications for clinical practice.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Alvarez Marta, Casas Paz, de Salazar Adolfo, Chueca Natalia, Guerrero-Beltran Carlos, Rodríguez Carmen, Imaz Arkaitz, Espinosa Nuria, García-Bujalance Silvia, Pérez-Elías María Jesús, García-Alvarez Mónica, Iribarren Jose Antonio, Santos Jesús, Dalmau David, Aguilera Antonio, Vinuesa David, Gutiérrez Félix, Piérola Beatriz, Molina José Miguel, Peraire Joaquim, Portilla Irene, Gómez-Sirvent Juan Luis, Olalla Julián, Galera Carlos, Blanco José Ramón, Riera Melchor, García-Fraile Lucio, Navarro Gemma, Curran Adrían, Poveda Eva, García Federico, CoRIS
Аннотация
OBJECTIVES: To study the prevalence of and the trend in transmitted drug resistance (TDR) to INSTIs in ART-naive patients in Spain.
METHODS: During the period 2012-17, 1109 patients from CoRIS were analysed. The Stanford algorithm v8.7 was used to evaluate TDR and transmission of clinically relevant resistance. To describe individual mutations/polymorphisms, the most recent IAS list (for INSTIs) and the 2009 WHO list update (for the backbone NRTIs used in combination with INSTIs in first-line treatment) were used.
RESULTS: Clinically relevant resistance to the INSTI class was 0.2%: T66I, 0.1%, resistance to elvitegravir and intermediate resistance to raltegravir; and G163K, 0.1%, intermediate resistance to raltegravir and elvitegravir. No clinical resistance to dolutegravir or bictegravir was observed. The prevalence of INSTI TDR following the IAS-USA INSTI mutation list was 2.6%, with no trend towards changes in the prevalence throughout the study period. The overall prevalence of NRTI WHO mutations was 4.3%, whereas clinically relevant resistance to tenofovir, abacavir and emtricitabine/lamivudine was 1.7%, 1.9% and 0.7%, respectively.
CONCLUSIONS: Given the low prevalence of clinically relevant resistance to INSTIs and first-line NRTIs in Spain, it is very unlikely that a newly diagnosed patient will present with clinical resistance to a first-line INSTI-based regimen. These patients may not benefit from INSTI and NRTI baseline resistance testing.