Evolution and predictors of HIV types-1 drug resistance in patients failing combinatin antiretroviral therapy in Italy

Simona Di Giambenedetto, Maurizio Zazzi, Paola Corsi, Angela Gonnelli, Massimo Di Pietro, Andrea Giacometti, Paolo Almi, Michele Trezzi, Enzo Boeri, Nicola Gianotti, Stefano Menzo, Romana Del Gobbo, Daniela Francisci, Alessandro Nerli, Luisa Galli, Andrea De Luca

Research output: Contribution to journalArticlepeer-review


Background: This study aimed to examine the evolution of genotypic drug resistance prevalence in treatment-failing patients in the multicentre, Italian, Antiretroviral Resistance Cohort Analysis (ARCA). Methods: Patients with a drug resistance genotype test performed between 1999 and 2006 at failure of a combination antiretroviral therapy and with complete treatment history were selected. The prevalence of resistance. was measured overall, per calendar year, per drug class and per treatment line at failure. Results: The Overall resistance prevalence was 81%. Resistance to nucleoside reverse transcriptase inhibitors (NRTIs) declined after 2002, (68% in 2006; for trend P=0.004); resistance to noh-NRTIs (NNRTIs) stabilized after 2004; and resistan to protease inhibitors (Pls) declined after 2001 (43% in 2006; P=0.004). In first-line failures, NRTI resistance decreased after 2002 (P=0.0006), NNRTI resistance decreased after 2003 (P=0.001) and PI resistapear decreased after 2001 (P+ T-cell counts, more recent calendar year and viral subtype B carriage, whereas the use of PI-based versus NNRTI-based regimens at failure was associated with a reduced risk of resistance. There was an increase of type-1 thymidine analogue and of protease mutations L33F, I47A/V, I50V and I54L/M whereas L90M decrease over calendar years. Conclusions: During more recent years, emerging drug resistance has decreased, particularly in first-line failures. The prevalence continues to be high in mutiregimen-failing patients.

Original languageEnglish
Pages (from-to)359-369
Number of pages11
JournalAntiviral Therapy
Issue number3
Publication statusPublished - 2009

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases


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