Widespread introduction of HIV integrase inhibitors into clinical care may result in appearance of drug resistance mutations affecting treatment outcome. The aim of our study was to monitor the resistance patterns of integrase inhibitors beside protease and reverse transcriptase inhibitors in newly diagnosed therapy-naive HIV-positive patients in Hungary between 2017 and 2019.Genotype-based resistance testing of HIV integrase, protease and reverse transcriptase was performed by amplification and Sanger population sequencing from plasma samples. Drug resistance mutations were identified by the algorithm of Stanford HIV Drug Resistance Database.Potentially transmitted, non-polymorphic integrase major mutation was detected in 1 out of 249 samples, while accessory mutations were observed in further 31 patients (12.4%). The overall prevalence of transmitted drug resistance (TDR) mutations related to protease and reverse transcriptase inhibitors was 5.8% (10/173) between the end of 2017 and 2019. Nucleoside reverse transcriptase inhibitor associated resistance mutations were the most frequent indicators of TDR (6/173; 3.5%), followed by resistance mutations associated with protease (3/173; 1.7%) and non-nucleoside reverse transcriptase inhibitors (2/173, 1.2%).The first detection of integrase major mutation and the changing patterns of other resistance mutations in Hungarian untreated HIV-positive population indicate the necessity of continuous molecular surveillance of Hungarian HIV epidemic.

中文翻译：

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匈牙利未接受过治疗的 HIV 阳性患者中与整合酶抑制剂相关的耐药突变的流行率。

将 HIV 整合酶抑制剂广泛引入临床护理可能会导致出现影响治疗结果的耐药性突变。我们研究的目的是监测 2017 年至 2019 年间匈牙利新诊断的未经治疗的 HIV 阳性患者中除蛋白酶和逆转录酶抑制剂之外的整合酶抑制剂的耐药模式。基于基因型的 HIV 整合酶、蛋白酶和逆转录酶耐药性检测通过对血浆样本的扩增和 Sanger 群体测序进行。耐药突变通过斯坦福艾滋病毒耐药数据库的算法进行鉴定。在249个样本中，有1个检测到潜在传播的非多态性整合酶主要突变，而在另外31名患者（12.4%）中观察到辅助突变。