Author/Editor		Oroz, Maja; Begovac, Josip; Planinić, Ana; Rokić, Filip; Lunar, Maja M.; Zorec, Tomaž Mark; Belužić, Robert; Korać, Petra; Vugrek, Oliver; Poljak, Mario; Židovec-Lepej, Snježana
Title		Analysis of HIV-1 diversity, primary drug resistance and transmission networks in Croatia
Type		članek
Vol. and No.		Letnik 9, št. 1
Publication year		2019
Volume		str. str. 1-14
ISSN		2045-2322 - Scientific reports
Language		eng
Abstract		Molecular epidemiology of HIV-1 infection in treatment-naive HIV-1 infected persons from Croatia was investigated. We included 403 persons, representing 92.4% of all HIV-positive individuals entering clinical care in Croatia in 2014%2017. Overall prevalence of transmitted drug resistance (TDR) was estimated at 16.4%. Resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside RTI (NNRTIs) and protease inhibitors (PIs) was found in 11.4%, 6.7% and 2.5% of persons, respectively. Triple-class resistance was determined in 2.2% of individuals. In addition, a single case (1.0%) of resistance to integrase strand-transfer inhibitors (InSTIs) was found. Deep sequencing was performed on 48 randomly selected samples and detected additional TDR mutations in 6 cases. Phylogenetic inference showed that 347/403 sequences (86.1%) were part of transmission clusters and identified forward transmission of resistance in Croatia, even that of triple-class resistance. The largest TDR cluster of 53 persons with T215S was estimated to originate in the year 1992. Our data show a continuing need for pre-treatment HIV resistance testing in Croatia. Even though a low prevalence of resistance to InSTI was observed, surveillance of TDR to InSTI should be continued.
Keywords		molecular epidemiology HIV-1 infection drug resistance molekularna epidemiologija okužbe z HIV-1 odpornost na zdravila