ArticleJournal of virus eradication2025
Prevalence of acquired resistance to HIV integrase strand transfer inhibitors (INSTIs) in clinical samples from treatment-experienced patients in Chile, 2012-2023.
Article in Journal of virus eradication, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- HIV-1 integrase inhibitor resistance in viraemic-treated individuals and baseline capsid diversity relevant to future lenacapavir therapy.The Journal of antimicrobial chemotherapy · 2026Article
- Targeting Human Immunodeficiency Virus Integrase Beyond the Active Site: The Discovery and Development of Allosteric Integrase Inhibitors.ChemMedChem · 2026Review
- Factors associated with circulating levels of IL-17A in a high HIV-burden population.Scientific reports · 2026Article
- Mutation-Tolerant Inhibition of HIV-1 Integrase Strand Transfer by Secondary Metabolites from the Endophytic FungusMicroorganisms · 2026Article
- Research progress on HIV-1 structural proteins and antiviral therapies.Frontiers in immunology · 2026Review
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Authors and funding
6 authors.
Funding
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Abstract
Background: Integrase strand transfer inhibitors (INSTIs) are widely used in HIV treatment, yet few large-scale studies have examined acquired resistance (AR) at the population level. This study assessed the prevalence, patterns, and clinical implications of AR to INSTIs in Chile over a 12-year period. Methods: We analyzed 5266 genotypic sequences from ART-experienced individuals with confirmed virological failure and INSTI-based regimens between 2012 and 2023. Resistance-associated mutations were classified using the Stanford HIVdb algorithm. Resistance trends were compared between pre-pandemic (2012-2019) and post-pandemic (2020-2023) periods. Results: High AR rates were observed for first-generation INSTIs: raltegravir (28 %) and elvitegravir (27.7 %). Lower resistance levels were found for dolutegravir (8.3 %), bictegravir (8.3 %), and cabotegravir (18.7 %). Major resistance mutations included N155H (25.2 %), Q148 H/K/R (17.2 %), and Y143R (14.3 %). Notably, Q148 H/K/R mutations were always found in combination with other major mutations. Subtype-specific differences were observed, with higher first-generation INSTI resistance in subtype F (55.6 %) than in subtype B (23.9 %). Post-pandemic resistance increased significantly for first-generation INSTIs (25 % vs. 31 %, p < 0.05). The mutation N155H, while not impacting DTG or BIC significantly, conferred intermediate resistance to CAB. CAB resistance was detected despite its absence in treatment protocols, likely due to cross-resistance pathways. Conclusions: Acquired INSTIs resistance in Chile is high, especially for first-generation drugs. These findings highlight the need for nationwide molecular surveillance and pre-treatment genotyping, particularly before initiating long-acting regimens such as CAB-LA. Strategic monitoring will be critical to maintaining the efficacy of current and next-generation INSTIs.
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