Pretreatment HIV-1 Resistance in Argentina: results from the second surveillance study following WHO guidelines (2019)

LAUFER, NATALIA; BOUZAS, MARÍA BELÉN; FERNÁNDEZ-GIULIANO, SILVINA; ZAPIOLA, INES; MAMMANA, LILIA; SALOMON, HORACIO; MONZANI, CECILIA; CASTRO, GONZALO; SUAREA ORNANI, MARIA LAURA; ROJAS MACHADO, PAULA; COCHON, NATALIA; ADASZKO, ARIEL; RAVASI, GIOVANNU; VILA, MARCELO; MAULEN, SERGIO; CERIOTTO, MARIANA; BARBAS, MARÍA GABRIELA; MARTINI NOVAS, SERGIO LEONARDO

AIDS RESEARCH AND HUMAN RETROVIRUSES

MARY ANN LIEBERT INC

Lugar: New York; Año: 2024

0889-2229

More than 62.000 individuals are currently on antiretroviral treatment within thepublic health system in Argentina. In 2019, more than 50% of people on ART receivedNNRTIs. In this context, the second nationwide HIV-1 pretreatment drug resistancesurveillance study was carried out between April and December 2019 to assess theprevalence of HIV-1 drug resistance in Argentina using the WHO guidelines. This was anationwide cross-sectional study enrolling consecutive 18-year-old and older individualsstarting ARVs at 19 ARV-dispensing centers. This allowed us to estimate a point prevalencerate of resistance-associated mutations (RAMs) with a confidence interval (CI) of 5% (for thetotal population and for those without antiretroviral exposure). Four-hundred forty-sevenindividuals were included in the study. The prevalence of mutations associated withresistance was detected in 27.7% (CI95 25.6-34.9%) of the population. For NNRTI, it was19.6% (CI95 16.3-24.5%), for INSTI 6.1% (CI95 6.1-11.9%), for NRTI 3% (CI95 1.9-5.9%) andfor PI 1.5% (CI95 0.7-3.6%). Naive individuals had variants of resistance to NRTIs in 16.8%(CI95 12.8-21.4) and 5.7% (CI95 2.9-15.9) to INSTI. For experienced individuals, theprevalence of variants associated with resistance was 30.38% (CI95 20.8-42.2) for NRTIs and7.7% (CI95 2.9-15.9) for INSTI. This study shows an increase in the frequency of nonpolymorphic resistance-associated mutations (RAMs) associated with resistance to NNTRI.This study generates the framework of evidence that supports the use of schemes based onhigh genetic barrier integrase inhibitors as the first line of treatment and the need for theuse of resistance test prior to prescribing schemes based on NNTRI. We report for the firsttime the presence of a natural polymorphism associated with the most prevalentrecombinant viral form in Argentina and the presence of a mutation linked to first-lineintegrase inhibitors such as raltegravir.