Prevalence of acquired resistance mutations in a large cohort of perinatally infected HIV-1 patients

Data of drug resistance mutations (DRMs) within the Italian vertically infected population are scarce. The aim of the present work was to assess the prevalence of DRMs in this setting. We retrospectively analysed HIV-1 pol sequences of vertically infected patients obtained from the Italian Antiviral Response Cohort Analysis (ARCA) database (https://www.dbarca.net/). Our queries were restricted to adults. DRMs were interpreted using the Stanford HIVDB resistance interpretation algorithm (https://hivdb.stanford.edu/hivdb/by-mutations/). Any modification of antiretroviral therapy after initiation was considered a change in the therapeutic regimen. Data from a total of 94 patients were analysed (Fig. 1). Patient clinical characteristics are summarized in Table 1. The population was exposed to a median of five different antiretroviral regimens (range, 1–35 regimens). Data about the ongoing antiretroviral regimen were recovered for 73 patients (78%). Fourteen (15%) had no DRMs. At least one major DRM to nucleos(t)ide reverse transcriptase inhibitors (N(t)RTIs) was found in 74 cases (79%), to nonnucleoside reverse transcriptase inhibitors (NNRTIs) in 61 (65%) cases, to protease inhibitors (PIs) in 33 cases (35%) and to integrase strand transfer inhibitor (INSTIs) in 7 (7%).