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Dynamics and phylogenetic relationships of HIV-1 transmitted drug resistance according to subtype in Italy over the years 2000–14

2017; Oxford University Press; Volume: 72; Issue: 10 Linguagem: Inglês

10.1093/jac/dkx231

1460-2091

Lavinia Fabeni, Claudia Alteri, Domenico Di Carlo, Nicoletta Orchi, Luca Carioti, Ada Bertoli, Caterina Gori, Federica Forbici, Fabio Continenza, Gaetano Maffongelli, Carmela Pinnetti, Alessandra Vergori, Annalisa Mondi, Adriana Ammassari, Vanni Borghi, Massimo Giuliani, Gabriella De Carli, Silvia Pittalis, Susanna Grisetti, Alfredo Pennica, Claudio Maria Mastroianni, Francesco Montella, Antonio Cristaudo, Cristina Mussini, Enrico Girardi, Massimo Andreoni, Andrea Antinori, Francesca Ceccherini‐Silberstein, Carlo Federico Perno, Maria Mercedes Santoro, Enrico Girardi, Maria Rosaria Capobianchi, Carlo Federico Perno, Nicoletta Orchi, Assunta Navarra, Antonio Palummieri, Isabella Abbate, Adriana Ammassari, Roberta D’Arrigo, Gabriella De Carli, Lavinia Fabeni, Federica Forbici, Francesco Maria Fusco, Caterina Gori, Susanna Grisetti, Angela Mariano, Emanuele Nicastri, Giuseppina Nurra, Carmela Pinnetti, Silvia Pittalis, Vincenzo Puro, Alessandro Sampaolesi, Maria Rosaria Sciarrone, Paola Scognamiglio, Marina Selleri, Catia Sias, Mauro Zaccarelli, Aldo Di Carlo, Massimo Giuliani, Vincenzo Vullo, Mario Falciano, Alfredo Pennica, F Errigo, P. Gattari, Laura Spizzichino, S Schito, Massimo Andreoni, Loredana Sarmati, Anna Rita Buonomini, Carlotta Cerva, Claudio Maria Mastroianni, Miriam Lichtner, V. S. Mercurio, E. Anzalone, A Pitorri, A Caterini, Stefano Aviani Barbacci,

Hepatitis C virus research

Transmitted drug-resistance (TDR) remains a critical aspect for the management of HIV-1-infected individuals. Thus, studying the dynamics of TDR is crucial to optimize HIV care. In total, 4323 HIV-1 protease/reverse-transcriptase sequences from drug-naive individuals diagnosed in north and central Italy between 2000 and 2014 were analysed. TDR was evaluated over time. Maximum-likelihood and Bayesian phylogenetic trees with bootstrap and Bayesian-probability supports defined transmission clusters. Most individuals were males (80.2%) and Italian (72.1%), with a median (IQR) age of 37 (30–45) years. MSM accounted for 42.2% of cases, followed by heterosexuals (36.4%). Non-B subtype infections accounted for 30.8% of the overall population and increased over time (<2005–14: 19.5%–38.5%, P < 0.0001), particularly among Italians (<2005–14: 6.5%–28.8%, P < 0.0001). TDR prevalence was 8.8% and increased over time in non-B subtypes (<2005–14: 2%–7.1%, P = 0.018). Overall, 467 transmission clusters (involving 1207 individuals; 27.9%) were identified. The prevalence of individuals grouping in transmission clusters increased over time in both B (<2005–14: 12.9%–33.5%, P = 0.001) and non-B subtypes (<2005–14: 18.4%–41.9%, P = 0.006). TDR transmission clusters were 13.3% within the overall cluster observed and dramatically increased in recent years (<2005–14: 14.3%–35.5%, P = 0.005). This recent increase was mainly due to non-B subtype-infected individuals, who were also more frequently involved in large transmission clusters than those infected with a B subtype [median number of individuals in transmission clusters: 7 (IQR 6–19) versus 4 (3–4), P = 0.047]. The epidemiology of HIV transmission changed greatly over time; the increasing number of transmission clusters (sometimes with drug resistance) shows that detection and proper treatment of the multi-transmitters is a major target for controlling HIV spread.