Aims: To evaluate the frequency of the InSTIs mutations in a large cohort of HIV-infected people.

Background: The Highly Active Anti-Retroviral Therapy (HAART) allows turning HIV infection from a fatal disease to chronic infection, and Integrase Strand Transfer Inhibitors (InSTIs) represent the cornerstone of this treatment. However, the spread of HIV-1 drug resistance mutations represents an emerging threat to the long-term success of HIV treatment programs.

Objectives: To evaluate the trend of the HIV drug resistance to InSTIs in a large cohort of HIVpositive people in order to assess the risk represented by these subjects in the spread of the HIV infection to the community.

Methods: A cross-sectional study was conducted analysing all the InSTIs resistance tests performed in HIV positive subjects during 2017-2019 by the HIV Laboratory of the University Hospital “Gaetano Martino” of Messina, Italy.

Results: In 2017-2019, 252 InSTIs resistance tests were performed, with 59 (23.4%), 88 (34.9%), and 105 (41.7%) tests respectively in the three considered years. Overall, 28 (11.1%) samples showed resistance to at least one of the four InSTIs. We observed a significant percentage increase of 95% in the resistance to all four drugs.

Conclusion: InSTI resistance is not rare. Therefore, continuous surveillance along with incessant health education and a wide offer of the HIV test, can be the most important tools in the fight against HIV infection.

目的：评估大量 HIV 感染者中 InSTI 突变的频率。

背景：高效抗逆转录病毒疗法 (HAART) 可以将 HIV 感染从致命疾病转变为慢性感染，而整合酶链转移抑制剂 (InSTI) 是这种治疗的基石。然而，HIV-1 耐药性突变的传播对 HIV 治疗计划的长期成功构成了新的威胁。

目的：评估大量 HIV 阳性人群中 HIV 对 InSTI 的耐药趋势，以评估这些受试者在 HIV 感染向社区传播中所代表的风险。

方法：一项横断面研究分析了意大利墨西拿大学医院“Gaetano Martino”的 HIV 实验室在 2017-2019 年期间在 HIV 阳性受试者中进行的所有 InSTI 耐药性测试。

结果：在 2017-2019 年，进行了 252 次 InSTI 耐药性测试，在三个考虑的年份分别进行了 59 次（23.4%）、88 次（34.9%）和 105 次（41.7%）次测试。总体而言，28 个 (11.1%) 样本显示出对四种 InSTI 中的至少一种具有抗性。我们观察到对所有四种药物的耐药性显着增加了 95%。

结论：InSTI 耐药并不罕见。因此，持续的监测、不断的健康教育和广泛的 HIV 检测可能是抗击 HIV 感染的最重要工具。