Primary resistance to integrase strand-transfer inhibitors in Europe

M. Casadellà; P. M. van Ham; M. Noguera-Julian; A. van Kessel; C. Pou; L. M. Hofstra; J. R. Santos; F. Garcia; D. Struck; I. Alexiev; A. M. Bakken Kran; A. I. Hoepelman; Leontios G. Kostrikis; S. Somogyi; K. Liitsola; M. Linka; C. Nielsen; D. Otelea; D. Paraskevis; M. Poljak; E. Puchhammer-Stöckl; D. Staneková; M. Stanojevic; K. Van Laethem; S. Zidovec Lepej; B. Clotet; C. A.B. Boucher; R. Paredes; A. M.J. Wensing; E. Puchhammer-Stöckl; M. Sarcletti; B. Schmied; M. Geit; G. Balluch; A. M. Vandamme; J. Vercauteren; I. Derdelinckx; A. Sasse; M. Bogaert; H. Ceunen; A. De Roo; S. De Wit; F. Echahidi; K. Fransen; J. C. Goffard; P. Goubau; E. Goudeseune; J. C. Yombi; P. Lacor; C. Liesnard; M. Moutschen; D. Pierard; R. Rens; Y. Schrooten; D. Vaira; L. P. Vandekerckhove; A. Van den Heuvel; B. Van Der Gucht; M. Van Ranst; E. Van Wijngaerden; B. Vandercam; M. Vekemans; C. Verhofstede; N. Clumeck; K. Van Laethem; D. Beshkov; I. Alexiev; S. Zidovec Lepej; J. Begovac; I. Demetriades; I. Kousiappa; V. Demetriou; J. Hezka; M. Linka; L. Machala; M. Maly; C. Nielsen; L. B. Jørgensen; J. Gerstoft; L. Mathiesen; C. Pedersen; H. Nielsen; A. Laursen; B. Kvinesdal; K. Liitsola; M. Ristola; J. Suni; J. Sutinen; O. Hamouda; C. Kücherer; T. Berg; P. Braun; G. Poggensee; M. Däumer; J. Eberle; H. Heiken; R. Kaiser; H. Knechten; K. Korn; H. Müller

doi:10.1093/jac/dkv202

Primary resistance to integrase strand-transfer inhibitors in Europe

M. Casadellà, P. M. van Ham, M. Noguera-Julian, A. van Kessel, C. Pou, L. M. Hofstra, J. R. Santos, F. Garcia, D. Struck, I. Alexiev, A. M. Bakken Kran, A. I. Hoepelman, Leontios G. Kostrikis, S. Somogyi, K. Liitsola, M. Linka, C. Nielsen, D. Otelea, D. Paraskevis, M. PoljakE. Puchhammer-Stöckl, D. Staneková, M. Stanojevic, K. Van Laethem, S. Zidovec Lepej, B. Clotet, C. A.B. Boucher, R. Paredes, A. M.J. Wensing, E. Puchhammer-Stöckl, M. Sarcletti, B. Schmied, M. Geit, G. Balluch, A. M. Vandamme, J. Vercauteren, I. Derdelinckx, A. Sasse, M. Bogaert, H. Ceunen, A. De Roo, S. De Wit, F. Echahidi, K. Fransen, J. C. Goffard, P. Goubau, E. Goudeseune, J. C. Yombi, P. Lacor, C. Liesnard, M. Moutschen, D. Pierard, R. Rens, Y. Schrooten, D. Vaira, L. P. Vandekerckhove, A. Van den Heuvel, B. Van Der Gucht, M. Van Ranst, E. Van Wijngaerden, B. Vandercam, M. Vekemans, C. Verhofstede, N. Clumeck, K. Van Laethem, D. Beshkov, I. Alexiev, S. Zidovec Lepej, J. Begovac, I. Demetriades, I. Kousiappa, V. Demetriou, J. Hezka, M. Linka, L. Machala, M. Maly, C. Nielsen, L. B. Jørgensen, J. Gerstoft, L. Mathiesen, C. Pedersen, H. Nielsen, A. Laursen, B. Kvinesdal, K. Liitsola, M. Ristola, J. Suni, J. Sutinen, O. Hamouda, C. Kücherer, T. Berg, P. Braun, G. Poggensee, M. Däumer, J. Eberle, H. Heiken, R. Kaiser, H. Knechten, K. Korn, H. Müller

Department of Medicine

Research output: Contribution to journal › Article › Research › peer-review

48 Citations (Scopus)

Abstract

© The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. Objectives: The objective of this study was to define the natural genotypic variation of the HIV-1 integrase gene across Europe for epidemiological surveillance of integrase strand-transfer inhibitor (InSTI) resistance. Methods: This was a multicentre, cross-sectional study within the European SPREAD HIV resistance surveillance programme. A representative set of 300 samples was selected from 1950 naive HIV-positive subjects newly diagnosed in 2006-07. The prevalence of InSTI resistance was evaluated using quality-controlled baseline population sequencing of integrase. Signature raltegravir, elvitegravir and dolutegravir resistance mutations were defined according to the IAS-USA 2014 list. In addition, all integrase substitutions relative to HXB2 were identified, including those with a Stanford HIVdb score=10 to at least one InSTI. To rule out circulation of minority InSTIresistant HIV, 65 samples were selected for 454 integrase sequencing. Results: For the population sequencing analysis, 278 samples were retrieved and successfully analysed. No signature resistance mutations to any of the InSTIswere detected. Eleven (4%) subjects hadmutations at resistance-associated positions with an HIVdb score =10. Of the 56 samples successfully analysed with 454 sequencing, no InSTI signature mutationsweredetected, whereas integrase substitutionswithanHIVdbscore=10were found in8(14.3%) individuals. Conclusions:No signature InSTI-resistant variantswere circulating in Europe before the introduction of InSTIs. However, polymorphisms contributing to InSTI resistancewere not rare. As InSTI use becomes more widespread, continuous surveillance of primary InSTI resistance is warranted. These data will be key to modelling the kinetics of InSTI resistance transmission in Europe in the coming years.

Original language	English
Pages (from-to)	2885-2888
Journal	Journal of Antimicrobial Chemotherapy
Volume	70
Issue number	10
DOIs	https://doi.org/10.1093/jac/dkv202
Publication status	Published - 1 Oct 2015

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1093/jac/dkv202

Cite this

Casadellà, M., van Ham, P. M., Noguera-Julian, M., van Kessel, A., Pou, C., Hofstra, L. M., Santos, J. R., Garcia, F., Struck, D., Alexiev, I., Bakken Kran, A. M., Hoepelman, A. I., Kostrikis, L. G., Somogyi, S., Liitsola, K., Linka, M., Nielsen, C., Otelea, D., Paraskevis, D., ... Müller, H. (2015). Primary resistance to integrase strand-transfer inhibitors in Europe. Journal of Antimicrobial Chemotherapy, 70(10), 2885-2888. https://doi.org/10.1093/jac/dkv202

Casadellà, M. ; van Ham, P. M. ; Noguera-Julian, M. ; van Kessel, A. ; Pou, C. ; Hofstra, L. M. ; Santos, J. R. ; Garcia, F. ; Struck, D. ; Alexiev, I. ; Bakken Kran, A. M. ; Hoepelman, A. I. ; Kostrikis, Leontios G. ; Somogyi, S. ; Liitsola, K. ; Linka, M. ; Nielsen, C. ; Otelea, D. ; Paraskevis, D. ; Poljak, M. ; Puchhammer-Stöckl, E. ; Staneková, D. ; Stanojevic, M. ; Van Laethem, K. ; Zidovec Lepej, S. ; Clotet, B. ; Boucher, C. A.B. ; Paredes, R. ; Wensing, A. M.J. ; Puchhammer-Stöckl, E. ; Sarcletti, M. ; Schmied, B. ; Geit, M. ; Balluch, G. ; Vandamme, A. M. ; Vercauteren, J. ; Derdelinckx, I. ; Sasse, A. ; Bogaert, M. ; Ceunen, H. ; De Roo, A. ; De Wit, S. ; Echahidi, F. ; Fransen, K. ; Goffard, J. C. ; Goubau, P. ; Goudeseune, E. ; Yombi, J. C. ; Lacor, P. ; Liesnard, C. ; Moutschen, M. ; Pierard, D. ; Rens, R. ; Schrooten, Y. ; Vaira, D. ; Vandekerckhove, L. P. ; Van den Heuvel, A. ; Van Der Gucht, B. ; Van Ranst, M. ; Van Wijngaerden, E. ; Vandercam, B. ; Vekemans, M. ; Verhofstede, C. ; Clumeck, N. ; Van Laethem, K. ; Beshkov, D. ; Alexiev, I. ; Zidovec Lepej, S. ; Begovac, J. ; Demetriades, I. ; Kousiappa, I. ; Demetriou, V. ; Hezka, J. ; Linka, M. ; Machala, L. ; Maly, M. ; Nielsen, C. ; Jørgensen, L. B. ; Gerstoft, J. ; Mathiesen, L. ; Pedersen, C. ; Nielsen, H. ; Laursen, A. ; Kvinesdal, B. ; Liitsola, K. ; Ristola, M. ; Suni, J. ; Sutinen, J. ; Hamouda, O. ; Kücherer, C. ; Berg, T. ; Braun, P. ; Poggensee, G. ; Däumer, M. ; Eberle, J. ; Heiken, H. ; Kaiser, R. ; Knechten, H. ; Korn, K. ; Müller, H. / Primary resistance to integrase strand-transfer inhibitors in Europe. In: Journal of Antimicrobial Chemotherapy. 2015 ; Vol. 70, No. 10. pp. 2885-2888.

@article{c0a22550f76f43f5a5972b50a913b023,

title = "Primary resistance to integrase strand-transfer inhibitors in Europe",

abstract = "{\textcopyright} The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. Objectives: The objective of this study was to define the natural genotypic variation of the HIV-1 integrase gene across Europe for epidemiological surveillance of integrase strand-transfer inhibitor (InSTI) resistance. Methods: This was a multicentre, cross-sectional study within the European SPREAD HIV resistance surveillance programme. A representative set of 300 samples was selected from 1950 naive HIV-positive subjects newly diagnosed in 2006-07. The prevalence of InSTI resistance was evaluated using quality-controlled baseline population sequencing of integrase. Signature raltegravir, elvitegravir and dolutegravir resistance mutations were defined according to the IAS-USA 2014 list. In addition, all integrase substitutions relative to HXB2 were identified, including those with a Stanford HIVdb score=10 to at least one InSTI. To rule out circulation of minority InSTIresistant HIV, 65 samples were selected for 454 integrase sequencing. Results: For the population sequencing analysis, 278 samples were retrieved and successfully analysed. No signature resistance mutations to any of the InSTIswere detected. Eleven (4%) subjects hadmutations at resistance-associated positions with an HIVdb score =10. Of the 56 samples successfully analysed with 454 sequencing, no InSTI signature mutationsweredetected, whereas integrase substitutionswithanHIVdbscore=10were found in8(14.3%) individuals. Conclusions:No signature InSTI-resistant variantswere circulating in Europe before the introduction of InSTIs. However, polymorphisms contributing to InSTI resistancewere not rare. As InSTI use becomes more widespread, continuous surveillance of primary InSTI resistance is warranted. These data will be key to modelling the kinetics of InSTI resistance transmission in Europe in the coming years.",

author = "M. Casadell{\`a} and {van Ham}, {P. M.} and M. Noguera-Julian and {van Kessel}, A. and C. Pou and Hofstra, {L. M.} and Santos, {J. R.} and F. Garcia and D. Struck and I. Alexiev and {Bakken Kran}, {A. M.} and Hoepelman, {A. I.} and Kostrikis, {Leontios G.} and S. Somogyi and K. Liitsola and M. Linka and C. Nielsen and D. Otelea and D. Paraskevis and M. Poljak and E. Puchhammer-St{\"o}ckl and D. Stanekov{\'a} and M. Stanojevic and {Van Laethem}, K. and {Zidovec Lepej}, S. and B. Clotet and Boucher, {C. A.B.} and R. Paredes and Wensing, {A. M.J.} and E. Puchhammer-St{\"o}ckl and M. Sarcletti and B. Schmied and M. Geit and G. Balluch and Vandamme, {A. M.} and J. Vercauteren and I. Derdelinckx and A. Sasse and M. Bogaert and H. Ceunen and {De Roo}, A. and {De Wit}, S. and F. Echahidi and K. Fransen and Goffard, {J. C.} and P. Goubau and E. Goudeseune and Yombi, {J. C.} and P. Lacor and C. Liesnard and M. Moutschen and D. Pierard and R. Rens and Y. Schrooten and D. Vaira and Vandekerckhove, {L. P.} and {Van den Heuvel}, A. and {Van Der Gucht}, B. and {Van Ranst}, M. and {Van Wijngaerden}, E. and B. Vandercam and M. Vekemans and C. Verhofstede and N. Clumeck and {Van Laethem}, K. and D. Beshkov and I. Alexiev and {Zidovec Lepej}, S. and J. Begovac and I. Demetriades and I. Kousiappa and V. Demetriou and J. Hezka and M. Linka and L. Machala and M. Maly and C. Nielsen and J{\o}rgensen, {L. B.} and J. Gerstoft and L. Mathiesen and C. Pedersen and H. Nielsen and A. Laursen and B. Kvinesdal and K. Liitsola and M. Ristola and J. Suni and J. Sutinen and O. Hamouda and C. K{\"u}cherer and T. Berg and P. Braun and G. Poggensee and M. D{\"a}umer and J. Eberle and H. Heiken and R. Kaiser and H. Knechten and K. Korn and H. M{\"u}ller",

year = "2015",

month = oct,

day = "1",

doi = "10.1093/jac/dkv202",

language = "English",

volume = "70",

pages = "2885--2888",

number = "10",

}

Casadellà, M, van Ham, PM, Noguera-Julian, M, van Kessel, A, Pou, C, Hofstra, LM, Santos, JR, Garcia, F, Struck, D, Alexiev, I, Bakken Kran, AM, Hoepelman, AI, Kostrikis, LG, Somogyi, S, Liitsola, K, Linka, M, Nielsen, C, Otelea, D, Paraskevis, D, Poljak, M, Puchhammer-Stöckl, E, Staneková, D, Stanojevic, M, Van Laethem, K, Zidovec Lepej, S, Clotet, B, Boucher, CAB, Paredes, R, Wensing, AMJ, Puchhammer-Stöckl, E, Sarcletti, M, Schmied, B, Geit, M, Balluch, G, Vandamme, AM, Vercauteren, J, Derdelinckx, I, Sasse, A, Bogaert, M, Ceunen, H, De Roo, A, De Wit, S, Echahidi, F, Fransen, K, Goffard, JC, Goubau, P, Goudeseune, E, Yombi, JC, Lacor, P, Liesnard, C, Moutschen, M, Pierard, D, Rens, R, Schrooten, Y, Vaira, D, Vandekerckhove, LP, Van den Heuvel, A, Van Der Gucht, B, Van Ranst, M, Van Wijngaerden, E, Vandercam, B, Vekemans, M, Verhofstede, C, Clumeck, N, Van Laethem, K, Beshkov, D, Alexiev, I, Zidovec Lepej, S, Begovac, J, Demetriades, I, Kousiappa, I, Demetriou, V, Hezka, J, Linka, M, Machala, L, Maly, M, Nielsen, C, Jørgensen, LB, Gerstoft, J, Mathiesen, L, Pedersen, C, Nielsen, H, Laursen, A, Kvinesdal, B, Liitsola, K, Ristola, M, Suni, J, Sutinen, J, Hamouda, O, Kücherer, C, Berg, T, Braun, P, Poggensee, G, Däumer, M, Eberle, J, Heiken, H, Kaiser, R, Knechten, H, Korn, K & Müller, H 2015, 'Primary resistance to integrase strand-transfer inhibitors in Europe', Journal of Antimicrobial Chemotherapy, vol. 70, no. 10, pp. 2885-2888. https://doi.org/10.1093/jac/dkv202

Primary resistance to integrase strand-transfer inhibitors in Europe. / Casadellà, M.; van Ham, P. M.; Noguera-Julian, M.; van Kessel, A.; Pou, C.; Hofstra, L. M.; Santos, J. R.; Garcia, F.; Struck, D.; Alexiev, I.; Bakken Kran, A. M.; Hoepelman, A. I.; Kostrikis, Leontios G.; Somogyi, S.; Liitsola, K.; Linka, M.; Nielsen, C.; Otelea, D.; Paraskevis, D.; Poljak, M.; Puchhammer-Stöckl, E.; Staneková, D.; Stanojevic, M.; Van Laethem, K.; Zidovec Lepej, S.; Clotet, B.; Boucher, C. A.B.; Paredes, R.; Wensing, A. M.J.; Puchhammer-Stöckl, E.; Sarcletti, M.; Schmied, B.; Geit, M.; Balluch, G.; Vandamme, A. M.; Vercauteren, J.; Derdelinckx, I.; Sasse, A.; Bogaert, M.; Ceunen, H.; De Roo, A.; De Wit, S.; Echahidi, F.; Fransen, K.; Goffard, J. C.; Goubau, P.; Goudeseune, E.; Yombi, J. C.; Lacor, P.; Liesnard, C.; Moutschen, M.; Pierard, D.; Rens, R.; Schrooten, Y.; Vaira, D.; Vandekerckhove, L. P.; Van den Heuvel, A.; Van Der Gucht, B.; Van Ranst, M.; Van Wijngaerden, E.; Vandercam, B.; Vekemans, M.; Verhofstede, C.; Clumeck, N.; Van Laethem, K.; Beshkov, D.; Alexiev, I.; Zidovec Lepej, S.; Begovac, J.; Demetriades, I.; Kousiappa, I.; Demetriou, V.; Hezka, J.; Linka, M.; Machala, L.; Maly, M.; Nielsen, C.; Jørgensen, L. B.; Gerstoft, J.; Mathiesen, L.; Pedersen, C.; Nielsen, H.; Laursen, A.; Kvinesdal, B.; Liitsola, K.; Ristola, M.; Suni, J.; Sutinen, J.; Hamouda, O.; Kücherer, C.; Berg, T.; Braun, P.; Poggensee, G.; Däumer, M.; Eberle, J.; Heiken, H.; Kaiser, R.; Knechten, H.; Korn, K.; Müller, H.

In: Journal of Antimicrobial Chemotherapy, Vol. 70, No. 10, 01.10.2015, p. 2885-2888.

Research output: Contribution to journal › Article › Research › peer-review

TY - JOUR

T1 - Primary resistance to integrase strand-transfer inhibitors in Europe

AU - Casadellà, M.

AU - van Ham, P. M.

AU - Noguera-Julian, M.

AU - van Kessel, A.

AU - Pou, C.

AU - Hofstra, L. M.

AU - Santos, J. R.

AU - Garcia, F.

AU - Struck, D.

AU - Alexiev, I.

AU - Bakken Kran, A. M.

AU - Hoepelman, A. I.

AU - Kostrikis, Leontios G.

AU - Somogyi, S.

AU - Liitsola, K.

AU - Linka, M.

AU - Nielsen, C.

AU - Otelea, D.

AU - Paraskevis, D.

AU - Poljak, M.

AU - Puchhammer-Stöckl, E.

AU - Staneková, D.

AU - Stanojevic, M.

AU - Van Laethem, K.

AU - Zidovec Lepej, S.

AU - Clotet, B.

AU - Boucher, C. A.B.

AU - Paredes, R.

AU - Wensing, A. M.J.

AU - Puchhammer-Stöckl, E.

AU - Sarcletti, M.

AU - Schmied, B.

AU - Geit, M.

AU - Balluch, G.

AU - Vandamme, A. M.

AU - Vercauteren, J.

AU - Derdelinckx, I.

AU - Sasse, A.

AU - Bogaert, M.

AU - Ceunen, H.

AU - De Roo, A.

AU - De Wit, S.

AU - Echahidi, F.

AU - Fransen, K.

AU - Goffard, J. C.

AU - Goubau, P.

AU - Goudeseune, E.

AU - Yombi, J. C.

AU - Lacor, P.

AU - Liesnard, C.

AU - Moutschen, M.

AU - Pierard, D.

AU - Rens, R.

AU - Schrooten, Y.

AU - Vaira, D.

AU - Vandekerckhove, L. P.

AU - Van den Heuvel, A.

AU - Van Der Gucht, B.

AU - Van Ranst, M.

AU - Van Wijngaerden, E.

AU - Vandercam, B.

AU - Vekemans, M.

AU - Verhofstede, C.

AU - Clumeck, N.

AU - Van Laethem, K.

AU - Beshkov, D.

AU - Alexiev, I.

AU - Zidovec Lepej, S.

AU - Begovac, J.

AU - Demetriades, I.

AU - Kousiappa, I.

AU - Demetriou, V.

AU - Hezka, J.

AU - Linka, M.

AU - Machala, L.

AU - Maly, M.

AU - Nielsen, C.

AU - Jørgensen, L. B.

AU - Gerstoft, J.

AU - Mathiesen, L.

AU - Pedersen, C.

AU - Nielsen, H.

AU - Laursen, A.

AU - Kvinesdal, B.

AU - Liitsola, K.

AU - Ristola, M.

AU - Suni, J.

AU - Sutinen, J.

AU - Hamouda, O.

AU - Kücherer, C.

AU - Berg, T.

AU - Braun, P.

AU - Poggensee, G.

AU - Däumer, M.

AU - Eberle, J.

AU - Heiken, H.

AU - Kaiser, R.

AU - Knechten, H.

AU - Korn, K.

AU - Müller, H.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. Objectives: The objective of this study was to define the natural genotypic variation of the HIV-1 integrase gene across Europe for epidemiological surveillance of integrase strand-transfer inhibitor (InSTI) resistance. Methods: This was a multicentre, cross-sectional study within the European SPREAD HIV resistance surveillance programme. A representative set of 300 samples was selected from 1950 naive HIV-positive subjects newly diagnosed in 2006-07. The prevalence of InSTI resistance was evaluated using quality-controlled baseline population sequencing of integrase. Signature raltegravir, elvitegravir and dolutegravir resistance mutations were defined according to the IAS-USA 2014 list. In addition, all integrase substitutions relative to HXB2 were identified, including those with a Stanford HIVdb score=10 to at least one InSTI. To rule out circulation of minority InSTIresistant HIV, 65 samples were selected for 454 integrase sequencing. Results: For the population sequencing analysis, 278 samples were retrieved and successfully analysed. No signature resistance mutations to any of the InSTIswere detected. Eleven (4%) subjects hadmutations at resistance-associated positions with an HIVdb score =10. Of the 56 samples successfully analysed with 454 sequencing, no InSTI signature mutationsweredetected, whereas integrase substitutionswithanHIVdbscore=10were found in8(14.3%) individuals. Conclusions:No signature InSTI-resistant variantswere circulating in Europe before the introduction of InSTIs. However, polymorphisms contributing to InSTI resistancewere not rare. As InSTI use becomes more widespread, continuous surveillance of primary InSTI resistance is warranted. These data will be key to modelling the kinetics of InSTI resistance transmission in Europe in the coming years.

AB - © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. Objectives: The objective of this study was to define the natural genotypic variation of the HIV-1 integrase gene across Europe for epidemiological surveillance of integrase strand-transfer inhibitor (InSTI) resistance. Methods: This was a multicentre, cross-sectional study within the European SPREAD HIV resistance surveillance programme. A representative set of 300 samples was selected from 1950 naive HIV-positive subjects newly diagnosed in 2006-07. The prevalence of InSTI resistance was evaluated using quality-controlled baseline population sequencing of integrase. Signature raltegravir, elvitegravir and dolutegravir resistance mutations were defined according to the IAS-USA 2014 list. In addition, all integrase substitutions relative to HXB2 were identified, including those with a Stanford HIVdb score=10 to at least one InSTI. To rule out circulation of minority InSTIresistant HIV, 65 samples were selected for 454 integrase sequencing. Results: For the population sequencing analysis, 278 samples were retrieved and successfully analysed. No signature resistance mutations to any of the InSTIswere detected. Eleven (4%) subjects hadmutations at resistance-associated positions with an HIVdb score =10. Of the 56 samples successfully analysed with 454 sequencing, no InSTI signature mutationsweredetected, whereas integrase substitutionswithanHIVdbscore=10were found in8(14.3%) individuals. Conclusions:No signature InSTI-resistant variantswere circulating in Europe before the introduction of InSTIs. However, polymorphisms contributing to InSTI resistancewere not rare. As InSTI use becomes more widespread, continuous surveillance of primary InSTI resistance is warranted. These data will be key to modelling the kinetics of InSTI resistance transmission in Europe in the coming years.

U2 - 10.1093/jac/dkv202

DO - 10.1093/jac/dkv202

M3 - Article

VL - 70

SP - 2885

EP - 2888

IS - 10

ER -

Primary resistance to integrase strand-transfer inhibitors in Europe

Abstract

UN SDGs

Access to Document

Fingerprint

Cite this