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Beware of resistance to 2nd-generation integrase inhibitors: A systematic meta-analysis of HIV-1 integrase inhibitors resistance and drug resistance mutations.
Liu, Shanshan; Yuan, Defu; Zhou, Ying; Wang, Bei; Hu, Haiyang.
Afiliación
  • Liu S; Department of Epidemiology and Health Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China.
  • Yuan D; Department of Epidemiology and Health Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China.
  • Zhou Y; Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
  • Wang B; Department of Epidemiology and Health Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China. Electronic address: wangbeilxb@163.com.
  • Hu H; Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China. Electronic address: huhaiyang@jscdc.cn.
Int J Antimicrob Agents ; 64(3): 107294, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39096940
ABSTRACT

OBJECTIVE:

Assessing the prevalence of resistance and drug resistance mutations (DRMs) in HIV/AIDS patients towards integrase strand transfer inhibitors (INSTIs), particularly the 2nd-generation INSTIs, provides evidence for rational clinical drug use.

METHODS:

A systematic search was conducted on five databases to identify relevant literature reporting original data on INSTIs resistance. Meta-analyses, cumulative meta-analyses, subgroup analyses and meta-regression analyses were performed using selected models based on the results of heterogeneity tests.

RESULTS:

A total of 81 studies were included in this analysis. The prevalence of pre-treatment drug resistance (PDR) to 1st-generation INSTIs and 2nd-generation INSTIs were 0.41% (95% CI 0.19%-0.70%) and 0.04% (95% CI 0.00%-0.13%), respectively; and the prevalence of acquired drug resistance (ADR) were 7.60% (95% CI 3.54%-12.92%) and 4.93% (95% CI 1.78%-9.36%), respectively, and ADR showed an increasing and then decreasing time trend. The results of subgroup analyses showed differences in ADR to 2nd-generation INSTIs between regions and economic levels, with the highest ADR of 12.83% (95% CI 3.24%-27.17%) in the European region. DRMs varied among HIV patients and reduced drug sensitivity to varying degrees.

CONCLUSION:

The prevalence of PDR and DRMs in 2nd-generation INSTIs is currently low, but as the use of DTG-based ART expands, population-level drug resistance monitoring and individual-level genetic testing should be strengthened in order to maximise treatment efficacy. Additionally, attention should be paid to ADR to INSTIs to provide personalised treatments for HIV-infected patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / VIH-1 / Inhibidores de Integrasa VIH / Integrasa de VIH / Farmacorresistencia Viral / Mutación Límite: Humans Idioma: En Revista: Int J Antimicrob Agents Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / VIH-1 / Inhibidores de Integrasa VIH / Integrasa de VIH / Farmacorresistencia Viral / Mutación Límite: Humans Idioma: En Revista: Int J Antimicrob Agents Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Países Bajos