Prevalence of HIV-1 inetgrase mutations related to resistance to dolutegravir in raltegravir naive and pretrated patients.

The prevalence of HIV-1 integrase mutations related to resistance to the next-generation integrase inhibitor (INI), dolutegravir (DTG), was assessed in 440 INI-naive subjects and in 120 patients failing a raltegravir (RTG)-containing regimes. Of the mutations selected by DTG in vitro, S153FY was not detected in any isolate while L101l and T124A were highly prevalent in both groups and significantly associated with non-B subtype. RTG-selected double and triple mutants, mostly the G140S/Q148H variant, were detected in only 32 (26.7%) RTG-treated patients. As L101l and T124A do not appear to exert any major effect in vivo and double and triple mutants resistante to DTG are infrequently selected by RTG, DTG can be effectively used in INI-naive patients and may retain activity in many patients failing RTG.