University of Zagreb School of Medicine, Zagreb, 10000, Croatia.
University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, 10000, Croatia.
Sci Rep. 2019 Nov 21;9(1):17307. doi: 10.1038/s41598-019-53520-8.
Molecular epidemiology of HIV-1 infection in treatment-naive HIV-1 infected persons from Croatia was investigated. We included 403 persons, representing 92.4% of all HIV-positive individuals entering clinical care in Croatia in 2014-2017. Overall prevalence of transmitted drug resistance (TDR) was estimated at 16.4%. Resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside RTI (NNRTIs) and protease inhibitors (PIs) was found in 11.4%, 6.7% and 2.5% of persons, respectively. Triple-class resistance was determined in 2.2% of individuals. In addition, a single case (1.0%) of resistance to integrase strand-transfer inhibitors (InSTIs) was found. Deep sequencing was performed on 48 randomly selected samples and detected additional TDR mutations in 6 cases. Phylogenetic inference showed that 347/403 sequences (86.1%) were part of transmission clusters and identified forward transmission of resistance in Croatia, even that of triple-class resistance. The largest TDR cluster of 53 persons with T215S was estimated to originate in the year 1992. Our data show a continuing need for pre-treatment HIV resistance testing in Croatia. Even though a low prevalence of resistance to InSTI was observed, surveillance of TDR to InSTI should be continued.
对来自克罗地亚的未经治疗的 HIV-1 感染者的 HIV-1 感染的分子流行病学进行了研究。我们纳入了 403 人，占 2014-2017 年期间进入克罗地亚临床护理的所有 HIV 阳性个体的 92.4%。总体传播耐药（TDR）的流行率估计为 16.4%。核苷逆转录酶抑制剂（NRTIs）、非核苷 RTIs（NNRTIs）和蛋白酶抑制剂（PIs）的耐药率分别为 11.4%、6.7%和 2.5%。三重耐药的比例为 2.2%。此外，还发现了 1 例（1.0%）对整合酶链转移抑制剂（InSTIs）的耐药。对 48 个随机选择的样本进行了深度测序，在 6 个病例中检测到了额外的 TDR 突变。系统发育推断表明，403 个序列中的 347 个（86.1%）是传播簇的一部分，表明克罗地亚存在耐药性的向前传播，甚至存在三重耐药性的传播。估计由 53 人组成的最大 TDR 簇携带 T215S，起源于 1992 年。我们的数据表明，克罗地亚仍然需要进行治疗前 HIV 耐药性检测。尽管观察到对 InSTI 的耐药率较低，但仍应继续监测对 InSTI 的 TDR。
