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Viruses
Special Issues
Viral Resistance
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Viral Resistance

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Viral Immunology, Vaccines, and Antivirals".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 1814

Special Issue Editor

Dr. Maria Antonia De Francesco

E-Mail Website
Guest Editor
Department of Molecular and Translational Medicine, Institute of Microbiology, Università degli Studi di Brescia, 25123 Brescia, Italy
Interests: antibiotic resistance; antiviral resistance; molecular epidemiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Viral infections are a major public health problem. Continuous viral transmission and increased selective pressure favor the continued emergence of viruses resistant to both vaccines and antiviral drugs.

Mostly, RNA viruses exhibit high mutation rates for the use of RNA dependent RNA polymerases which lack proofreading activity. In this group are included, for example, Coronavirus, Ebola virus, Hepatitis C virus, Dengue virus, Zika virus, Chikungunya virus, Flu A virus, and Enterovirus.

Among DNA viruses, Hepatitis B virus and Cytomegalovirus showed high rates of genetic variability and great ability to develop drug resistance, respectively.

Today, several antiviral approaches are available, but they have several limitations such as the presence of side effects and the appearance of drug resistance that affect their clinical efficacy. Innovative approaches in the study of antiviral drugs can be fundamental in combating the problem of resistance. These strategies include technologies that increase the affinity of the drug for the target, reducing interactions with mutated binding pockets.

Furthermore, other approaches such as virtual screening, targeted protein/RNA degradation, resistance analysis during drug design, genetic editing, and RNA interference might be useful in fighting the emergence of drug resistance.

This Special Issue aims to provide the latest findings on antiviral resistance mechanisms, epidemiology, and all the aspects related to this topic. We invite experts from around the world to submit research articles, reviews, and systematic reviews about different topics, such as:

  • Emergence of DNA and RNA viruses resistant to antivirals;
  • Identification of new resistance mutation or resistance mechanism;
  • Drug mechanisms of action;
  • Viral escape against drug therapy;
  • Drug design principles to limit resistance development;
  • Discovery of new drugs;
  • New drug formulations.

Dr. Maria Antonia De Francesco
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Viruses is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antiviral drugs
  • resistance
  • mechanism
  • mutations
  • viral escape
  • viral adaptation
  • variability
  • combination therapy

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Published Papers (2 papers)

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Research

14 pages, 770 KiB  
Article
Prevalence of Doravirine Resistance Mutations in a Large-Scale HIV-1 Transmitted Drug Resistance Survey in Buenos Aires, Argentina
by Diego Cecchini, Isabel Cassetti, Florencia Scarnato, Agustina Fiori, Jimena Nuevo, Clara Villaverde, Adriana Sucari, María C. Torroija, Emiliano Bissio, Gabriela Bugarin and Gustavo Lopardo
Viruses 2025, 17(5), 731; https://doi.org/10.3390/v17050731 - 20 May 2025
Abstract
Background: Argentina has reported moderate to high levels of transmitted drug resistance in people living with HIV/AIDS (PLWHA), mostly to non-nucleoside reverse transcriptase inhibitors (NNRTIs). Doravirine (DOR) has a unique resistance profile and retains potent antiviral activity in the presence of the most [...] Read more.
Background: Argentina has reported moderate to high levels of transmitted drug resistance in people living with HIV/AIDS (PLWHA), mostly to non-nucleoside reverse transcriptase inhibitors (NNRTIs). Doravirine (DOR) has a unique resistance profile and retains potent antiviral activity in the presence of the most prevalent NNRTI-associated resistant viruses. Scarce data exist regarding the frequency of DOR resistance-associated mutations (RAMs) in Latin America. We describe the prevalence of DOR RAMs in samples from adults PLWHA in Buenos Aires, Argentina, in the context of a survey of transmitted drug resistance (TDR). Material and Methods: A cross-sectional study was undertaken utilizing samples collected between 2017 and 2021 at two reference HIV clinics. Samples were analyzed for RAMs using the World Health Organization (WHO) mutation list. Mutations to DOR were assessed with the Stanford and Agence Nationale de Recherches sur le SIDA (ANRS) algorithms. Rilpivirine (RPV) RAMs were assessed using the Stanford algorithm. Susceptibility to NNRTIs was evaluated using the HIVdb Program with Stanford and ANRS criteria. Results: Samples from 1667 PLWHA were analyzed: 81.2% were male, with 52.6% identifying as men who have sex with men. According to the WHO list, the overall TDR was 12.1% (n = 203). The prevalence of RAMs was 10.1% (170/1667) for NNRTIs, 4% (67/1667) for nucleoside reverse-transcriptase inhibitors (NRTIs), and 1.7% (30/1667) for protease inhibitors (PIs). The most frequent NNRTI mutations were K103N (5.6%), G190A (0.89%), and K103S (0.77%). The prevalence of DOR RAMs was <2%, with the most common being Y188L (0.53%). Rilpivirine RAM prevalence was 6%. Susceptibility to DOR, RPV, efavirenz, and nevirapine as given by the Stanford algorithm was 97.4%, 92%, 91.4%, and 90.4%, respectively. The ANRS criteria yielded susceptibility rates of 98.3%, 93.3%, 92.3%, and 90.8%, respectively. Regarding NRTIs, thymidine analog mutations (including T215 revertants) were the most frequent RAMs. Among PIs, the most prevalent RAMs were M46L (0.47%) and V82A (0.35%). Conclusions: Our study shows the persistence of moderate to high levels of resistance to first-generation NNRTIs. Despite this, prevalence was low for DOR. Surveillance of TDR remains critical for recommendations of ART initiation. Full article
(This article belongs to the Special Issue Viral Resistance)
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15 pages, 1185 KiB  
Article
Patterns of Transmitted Drug Resistance Mutations and HIV-1 Subtype Dynamics in ART-Naïve Individuals in Veneto, Italy, from 2017 to 2024
by Nicholas Geremia, Monica Basso, Andrea De Vito, Renzo Scaggiante, Mario Giobbia, Giuliana Battagin, Federico Dal Bello, Maria Teresa Giordani, Stefano Nardi, Marina Malena, Annamaria Cattelan and Saverio Giuseppe Parisi
Viruses 2024, 16(9), 1393; https://doi.org/10.3390/v16091393 - 30 Aug 2024
Cited by 1 | Viewed by 1280
Abstract
This study investigates the prevalence and patterns of transmitted drug resistance mutations (TDRMs) and HIV-1 subtypes among antiretroviral therapy (ART) naïve individuals in Veneto, Italy, from 2017 to 2024. This research aims to understand the dynamic landscape of TDRMs and HIV-1 genetic diversity [...] Read more.
This study investigates the prevalence and patterns of transmitted drug resistance mutations (TDRMs) and HIV-1 subtypes among antiretroviral therapy (ART) naïve individuals in Veneto, Italy, from 2017 to 2024. This research aims to understand the dynamic landscape of TDRMs and HIV-1 genetic diversity to inform treatment strategies effectively. We included all adult ART-naïve people with HIV (PWH) from seven infectious disease units in Veneto, Italy. We collected the genotypic resistance testing conducted to predict drug susceptibility and subtype distribution using the Stanford HIVdb algorithm. We included 762 PWH, showing a slight but statistically significant decline in the B subtype among Italian PWH (p = 0.045) and an increase in non-B subtypes among foreigners, though it was not statistically significant (p = 0.333). The most frequent mutations were in Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs), especially in non-B subtypes, with a notable rise from 10.7% in 2017–2019 to 15.5% in 2020–2024. Notably, TDRMs were consistently detected, highlighting an ongoing challenge despite the stable prevalence observed over the years. In addition, the data revealed a concerning rise in mutations against newer drug classes, such as integrase inhibitors. Conclusively, the study underscores the necessity of continuous surveillance of HIV subtypes and resistance patterns to adapt ART regimens optimally. Despite the stable levels of drug resistance, the emergence of resistance against newer drugs necessitates ongoing vigilance and possible adjustment in treatment protocols to enhance clinical outcomes and manage HIV drug resistance effectively. Full article
(This article belongs to the Special Issue Viral Resistance)
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