Primary HIV-1 Antiretroviral Resistance in a Private Health Care Institution in the City of Buenos Aires, Argentina

Abstract

Introduction: HIV genome mutations are the leading cause of therapeutic failure in HIV-1 infections. Mutations associated with resistance to the antiretroviral treatment are either a consequence of an infection with resistant viruses (primary resistance) or a consequence of pharmacological pressure (secondary resistance). Primary resistance prevalence can be classified as high, moderate or low according to the percentage of patients with resistance-associated mutations. Objective: The aim of this investigation was to study the prevalence of HIV-1 primary antiretroviral resistance (PAR) at our institution, and to evaluate the resistance profiles and the associated mutations. Materials and methods: HIV-1 genotypic resistance studies in naive patients from 2015-2022 were retrospectively analyzed. Mutations were defined according to the criteria of the World Health Organization (2015-2017) and Stanford University (2018-2022). Results: A total of 368 naive patients were included. Total PAR was 19.8%. The PAR rate (most frequent mutations) to non-nucleoside reverse transcriptase inhibitors was 15.6% (K103N), that to nucleoside reverse transcriptase inhibitors was 4.9% (M41L and M184V), and that to protease inhibitors was 4.1% (M46L, M46I, V82A, I54V and K43T). Besides, 21.9% of the patients presented resistance to more than one pharmacological group. Conclusion: PAR information in Argentina is limited. The PAR levels recorded were high (19.8%). These results could contribute to the development of new clinical guidelines, which would make antiretroviral treatment optimization possible.