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The Continuous Surveillance of InSTI Resistance Could be an Important Public Health Tool in the Fight Against HIV Infection

[ Vol. 19 , Issue. 4 ]

Author(s):

Giuseppa Visalli, Alessio Facciolà*, Maria Giovanna Costanzo and Angela Di Pietro   Pages 358 - 367 ( 10 )

Abstract:


Aims: To evaluate the frequency of the InSTIs mutations in a large cohort of HIV-infected people.

Background: The Highly Active Anti-Retroviral Therapy (HAART) allows turning HIV infection from a fatal disease to chronic infection, and Integrase Strand Transfer Inhibitors (InSTIs) represent the cornerstone of this treatment. However, the spread of HIV-1 drug resistance mutations represents an emerging threat to the long-term success of HIV treatment programs.

Objectives: To evaluate the trend of the HIV drug resistance to InSTIs in a large cohort of HIVpositive people in order to assess the risk represented by these subjects in the spread of the HIV infection to the community.

Methods: A cross-sectional study was conducted analysing all the InSTIs resistance tests performed in HIV positive subjects during 2017-2019 by the HIV Laboratory of the University Hospital “Gaetano Martino” of Messina, Italy.

Results: In 2017-2019, 252 InSTIs resistance tests were performed, with 59 (23.4%), 88 (34.9%), and 105 (41.7%) tests respectively in the three considered years. Overall, 28 (11.1%) samples showed resistance to at least one of the four InSTIs. We observed a significant percentage increase of 95% in the resistance to all four drugs.

Conclusion: InSTI resistance is not rare. Therefore, continuous surveillance along with incessant health education and a wide offer of the HIV test, can be the most important tools in the fight against HIV infection.

Keywords:

HIV infection, highly active antiRetroviral therapy, drug resistance, surveillance, undetectable viral load, public health.

Affiliation:

Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina

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