RT Journal Article T1 Integrase inhibitor (INI) genotypic resistance in treatment-naive and raltegravir-experienced patients infected with diverse HIV-1 clades. A1 Doyle, Tomas A1 Dunn, David T A1 Ceccherini-Silberstein, Francesca A1 De Mendoza, Carmen A1 Garcia, Frederico A1 Smit, Erasmus A1 Fearnhill, Esther A1 Marcelin, Anne-Genevieve A1 Martinez-Picado, Javier A1 Kaiser, Rolf A1 Geretti, Anna Maria K1 Estudios de cohortes K1 Farmacorresistencia viral K1 Fármacos anti-VIH K1 Europa (continente) K1 Infecciones por VIH K1 VIH-1 K1 Inhibidores de integrasa K1 Mutación Missense AB OBJECTIVESThe aim of this study was to characterize the prevalence and patterns of genotypic integrase inhibitor (INI) resistance in relation to HIV-1 clade.METHODSThe cohort comprised 533 INI-naive subjects and 255 raltegravir recipients with viraemia who underwent integrase sequencing in routine care across Europe, including 134/533 (25.1%) and 46/255 (18.0%), respectively, with non-B clades (A, C, D, F, G, CRF01, CRF02, other CRFs, complex).RESULTSNo major INI resistance-associated mutations (RAMs) occurred in INI-naive subjects. Among raltegravir recipients with viraemia (median 3523 HIV-1 RNA copies/mL), 113/255 (44.3%) had one or more major INI RAMs, most commonly N155H (45/255, 17.6%), Q148H/R/K + G140S/A (35/255, 13.7%) and Y143R/C/H (12/255, 4.7%). In addition, four (1.6%) raltegravir recipients showed novel mutations at recognized resistance sites (E92A, S147I, N155D, N155Q) and novel mutations at other integrase positions that were statistically associated with raltegravir exposure (K159Q/R, I161L/M/T/V, E170A/G). Comparing subtype B with non-B clades, Q148H/R/K occurred in 42/209 (20.1%) versus 2/46 (4.3%) subjects (P = 0.009) and G140S/A occurred in 36/209 (17.2%) versus 1/46 (2.2%) subjects (P = 0.005). Intermediate- to high-level cross-resistance to twice-daily dolutegravir was predicted in 40/255 (15.7%) subjects, more commonly in subtype B versus non-B clades (39/209, 18.7% versus 1/46, 2.2%; P = 0.003). A glycine (G) to serine (S) substitution at integrase position 140 required one nucleotide change in subtype B and two nucleotide changes in all non-B clades.CONCLUSIONSNo major INI resistance mutations occurred in INI-naive subjects. Reduced occurrence of Q148H/R/K + G140S/A was seen in non-B clades versus subtype B, and was explained by the higher genetic barrier to the G140S mutation observed in all non-B clades analysed. PB Oxford University Press SN 0305-7453 YR 2015 FD 2015-11 LK http://hdl.handle.net/10668/2506 UL http://hdl.handle.net/10668/2506 LA en NO Doyle T, Dunn DT, Ceccherini-Silberstein F, De Mendoza C, Garcia F, Smit E, et al. Integrase inhibitor (INI) genotypic resistance in treatment-naive and raltegravir-experienced patients infected with diverse HIV-1 clades. J Antimicrob Chemother. 2015; 70(11):3080-6 NO Journal Article; Research Support, Non-U.S. Gov't; DS RISalud RD Apr 8, 2025