A Global Registry On Second gEneration and Long-acting inTegrase inhibiTor fAilures

The ROSETTA study collects clinical data and HIV sequences from individuals experiencing failure of ART containing second generation INSTIs from Americas, Africa and Europe. If resistance testing is not available, the ROSETTA team can perform genotypic resistance testing of RT, protease, integrase and 3'-PPT.

Research objectives:

To set up a database with data of individuals who have experienced virological failure on a regimen containing a second generation INSTI To determine the prevalence of resistance mutations in integrase and 3'-PPT in the dataset To identify possible new resistance mutations outside integrase and 3'-PPT. providing additional funding is retrieved.

The study design will be a multicenter observational cohort study. Patients will be included from HIV care centers in Europe, America and Africa, if they fullfill the inclusion criteria.

Inclusion criteria

• Confirmed HIV-1 infection
• Using cART (any regimen) for at least the last 6 months
• Experiencing virological failure* on a second generation INSTI-containing regimen (including monotherapy and dual-therapy regimens)
• Data on current regimen and previous INSTI exposure available (start/stop dates and dosing mandatory)
• Integrase genotypic data available (performed locally) or a plasma/DBS (or CSF if available) sample(s) drawn at time of failure available to perform genotypic testing centrally * Virological failure is defined as at least 2 consecutive viral loads (VL) above 50 copies/mL in plasma or 1 VL above 200 copies/mL in plasma. We will also include patients who have a VL of >50 copies/mL in CSF, independent of the VL in plasma.

Exclusion criteria

• Submitted fasta file not passing quality control and unavailability of a stored sample to repeat sequence analysis
• Missing Mandatory data
• Documented treatment interruption for at least 2 weeks prior to viral load testing.