Despite the success of antiretroviral treatment (ART), the persisting transmitted drug resistance (TDR) and HIV genetic heterogeneity affect treatment efficacy. We explored the prevalence of TDR among ART-naïve HIV patients in Greece during the period 2016-2019.
Genotypic resistance testing was available for 438 ART-naïve HIV patients. Multivariable Poisson regressions were fitted.
The majority of patients were males with a slight predominance of Hellenic (26.5%) over non-Hellenic (21.9%) nationality. The prevalence of TDR was 7.8% with a predominance of mutations for non-nucleoside reverse-transcriptase inhibitors (5.7%) over nucleoside reverse-transcriptase inhibitors (0.2%). No mutations to protease inhibitors were detected. The resistance prevalence was 22.1% based on all mutations identified through the HIVdb interpretation system. The most frequent resistant sites were E138A (9.6%), K103N (6.4%) and K101E (2.1%). The majority of detected mutations were confined to subtype A (52.6%) followed by B (19.6%). Non-Hellenic nationality was statistically significantly associated with increased risk for TDR (relative risk: 1.32, 95% confidence intervals: 1.04-1.69).
Non-B HIV infections predominate in Greece with an increasing trend in recent years. The prevalence of TDR remains stable. The ongoing surveillance of resistance testing is needed to secure the long-term success of ART.