Short Communication: Integrase Strand Transfer Inhibitors Drug Resistance Mutations in Puerto Rico HIV-Positive Individuals

Abstract

The HIV-1 integrase viral protein is responsible for incorporating the viral DNA into the genomic DNA. The inhibition of viral integration into host cell DNA is part of recent therapeutic procedures. Combination therapy with protease and reverse transcriptase inhibitors has demonstrated good synergistic results in reducing viral replication. The purpose of this study is to assess the occurrence of integrase drug resistance mutations from the period comprising 2013 through 2018 in Puerto Rico (PR). We analyzed 131 nucleotide sequences available in our HIV genotyping database, and we performed drug resistance mutation analyses using the Stanford HIV Drug Resistance Database. Twenty-one sequences (16.03%) harbored major or resistance-associated mutations. We identified the Q148HKR, G140S, Y143R, N155H, S147G, and E138EA major drug resistance mutations and the D232DN, T97TA, E157Q, G163GART accessory mutations. We detected high-level drug resistance to Elvitegravir and Raltegravir (76.19% and 85.71%). Moreover, we identified sequences harboring drug resistance mutations that could provide resistance to Dolutegravir. The transmission of strains with integrase antiretroviral resistance has been previously documented in treatment naïve patients. Given the increase of patients treated with integrase inhibitors, surveillance of drug resistance mutations is an essential aspect of PR’s clinical management of HIV infection.

Current Progress in Genomic and Genetic Research on Human Viral Diseases

“…The United States Food and Drug Administration (United States FDA) has approved the following five drugs for clinical use: dolutegravir (DTG), raltegravir (RAL), elvitegravir (EVG), bictegravir (BIC), and cabotegravir (CAB). Despite integrase inhibitors plays an effective role in antiretroviral action with a novel mechanism of action, resistance is inevitable (Jiang et al, 2016), and previously published studies have shown that there were important INSTIs resistance mutations in newly diagnosed HIV-1 patients in Spain, Canada, and the United States (Stekler et al, 2015;Ji et al, 2018;Casadellà et al, 2020;López et al, 2021). Major INSTIs resistance mutations have also been discovered in Yunnan (Deng et al, 2019) and Jiangsu (Yin et al, 2021) in China, and INSTIs resistance mutations were found in our neighboring provinces such as Henan (Yang et al, 2021), Beijing (Yu et al, 2022).…”

Prevalence of resistance mutations associated with integrase inhibitors in therapy-naive HIV-positive patients in Baoding, Hebei province, China

“…The United States Food and Drug Administration (United States FDA) has approved the following five drugs for clinical use: dolutegravir (DTG), raltegravir (RAL), elvitegravir (EVG), bictegravir (BIC), and cabotegravir (CAB). Despite integrase inhibitors plays an effective role in antiretroviral action with a novel mechanism of action, resistance is inevitable ( Jiang et al, 2016 ), and previously published studies have shown that there were important INSTIs resistance mutations in newly diagnosed HIV-1 patients in Spain, Canada, and the United States ( Stekler et al, 2015 ; Ji et al, 2018 ; Casadellà et al, 2020 ; López et al, 2021 ). Major INSTIs resistance mutations have also been discovered in Yunnan ( Deng et al, 2019 ) and Jiangsu ( Yin et al, 2021 ) in China, and INSTIs resistance mutations were found in our neighboring provinces such as Henan ( Yang et al, 2021 ), Beijing ( Yu et al, 2022 ).…”