HIV-1 transmitted drug resistance in Slovenia and its impact on predicted treatment effectiveness: 2011–2016 update

<div><p>Abstract</p><p>HIV-positive individuals that have a detected transmitted drug resistance (TDR) at baseline have a higher risk of virological failure with antiretroviral therapy (ART). This study offers an update on the prevalence of TDR in Slovenia, looks for onward transmission of TDR, and reassesses the need for baseline drug resistance testing. Blinded questionnaires and partial <i>pol</i> sequences were obtained from 54.5% (168/308) of all of the patients diagnosed with HIV-1 from 2011 to 2016. Subtype B was detected in 82.7% (139/168) of patients, followed by subtype A (8.3%), subtype C (2.4%), and CRF01_AE (1.8%). Surveillance drug resistance mutations (SDRMs) were found in four individuals (2.4%), all of them men who have sex with men (MSM) and infected with subtype B. K103N was detected in two patients and T68D and T215D in one person each, corresponding to a prevalence of 0%, 1.2%, and 1.2% of TDR to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs), and non-NRTIs (NNRTIs), respectively. The impact of mutations on drug susceptibility was found to be most pronounced for NNRTIs. No forward spread of TDR within the country was observed; however, phylogenetic analysis revealed several new introductions of HIV into Slovenia in recent years, possibly due to increased risky behavior by MSM. This was indirectly confirmed by a substantial increase in syphilis cases and HIV-1 non-B subtypes during the study period. A drug-resistant HIV variant with good transmission fitness is thus more likely to be imported into Slovenia in the near future, and so TDR should be closely monitored.</p></div

Distribution of genotypic sensitivity scores of recommended first-line regimen as predicted from baseline HIV protease and reverse-transcriptase sequences obtained from individuals diagnosed with HIV-1 in Slovenia, 2000 to 2016.

<p>Distribution of genotypic sensitivity scores of recommended first-line regimen as predicted from baseline HIV protease and reverse-transcriptase sequences obtained from individuals diagnosed with HIV-1 in Slovenia, 2000 to 2016.</p

Large phylogenetic clusters (<i>n</i> > 10) of Slovenian sequences subtyped B or B-like.

<p>Large phylogenetic clusters (<i>n</i> > 10) of Slovenian sequences subtyped B or B-like.</p

Characteristics of individuals diagnosed with HIV-1 in Slovenia, 2011–2016.

<p>Characteristics of individuals diagnosed with HIV-1 in Slovenia, 2011–2016.</p

Genotypic sensitivity scores (GSSs) of individual antiretroviral drugs as estimated from sequences obtained from individuals diagnosed with HIV-1 in Slovenia, 2000–2010 and 2011–2016.

<p>ATV = atazanavir; r = ritonavir (protease inhibitor booster); DRV = darunavir; LPV = lopinavir; ABC = abacavir; AZT = zidovudine; FTC = emtricitabine; 3TC = lamivudine; TDF = tenofovir; EFV = efavirenz; ETR = etravirine; NVP = nevirapine; RPV = rilpivirine.</p

Maximum likelihood phylogenetic tree of Slovenian sequences subtyped B or B-like and corresponding control sequences.

<p>Slovenian sequences from the 2011–2016 dataset are colored green, with sequences carrying surveillance drug resistance mutations (SDRMs) colored red; sequences from the 2000–2010 dataset are colored blue, with sequences carrying SDRMs colored purple; and control sequences are shown in black. Identified SDRMs are depicted next to the corresponding sequences. Phylogenetic clusters with approximate likelihood ratio test values (aLRT) > 0.95 are highlighted; clusters with ≥ 90% of Slovenian sequences are highlighted yellow and clusters with > 10% of foreign sequences are highlighted green.</p

Robust saliva-based RNA extraction-free one-step nucleic acid amplification test for mass SARS-CoV-2 monitoring

Early diagnosis with rapid detection of the virus plays a key role in preventing the spread of infection and in treating patients effectively. In order to address the need for a straightforward detection of SARS-CoV-2 infection and assessment of viral spread, we developed rapid, sensitive, extraction-free one-step reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and reverse transcription loop-mediated isothermal amplification (RT-LAMP) tests for detecting SARS-CoV-2 in saliva. We analyzed over 700 matched pairs of saliva and nasopharyngeal swab (NSB) specimens from asymptomatic and symptomatic individuals. Saliva, as either an oral cavity swab or passive drool, was collected in an RNA stabilization buffer. The stabilized saliva specimens were heat-treated and directly analyzed without RNA extraction. The diagnostic sensitivity of saliva-based RT-qPCR was at least 95% in individuals with subclinical infection and outperformed RT-LAMP, which had at least 70% sensitivity when compared to NSBs analyzed with a clinical RT-qPCR test. The diagnostic sensitivity for passive drool saliva was higher than that of oral cavity swab specimens (95% and 87%, respectively). A rapid, sensitive one-step extraction-free RT-qPCR test for detecting SARS-CoV-2 in passive drool saliva is operationally simple and can be easily implemented using existing testing sites, thus allowing high-throughput, rapid, and repeated testing of large populations. Furthermore, saliva testing is adequate to detect individuals in an asymptomatic screening program and can help improve voluntary screening compliance for those individuals averse to various forms of nasal collections

Andes Bags Co

Andes Bags Co es un proyecto apoyado por el centro de emprendimiento de la universidad del rosario junto con el apoyo de la fábrica familiar MAI GROUP S.AS, donde el primer objetivo está enfocado en la manufactura y el diseño de artículos impermeables que gracias a su estética y funcionalidad pueda suplir necesidades específicas de sus clientes . En este documento encontraras información acerca de un proyecto de confección en Colombia.Andes Bags Co es un proyecto apoyado por el centro de emprendimiento de la universidad del rosario junto con el apoyo de la fábrica familiar MAI GROUP S.AS, donde el primer objetivo está enfocado en la manufactura y el diseño de artículos impermeables que gracias a su estética y funcionalidad pueda suplir necesidades específicas de sus clientes . En este documento encontraras información acerca de un proyecto de confección en Colombia