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Integrase strand-transfer inhibitor polymorphic and accessory resistance substitutions in patients with acute/recent HIV infection-authors' response.

Similarly, the NRTI mutation patterns detected in our patients evoke almost outdated drugs; conversely, we never found M184V, which has been positively correlated with HIV-RNA levels of patients treated with drugs in current regimens. Overall, these observations indicate that nowadays nonresponding patients cannot be considered the unique origin of transmitted drug resistance; instead, we are convinced that we are facing an unexpected scenario, in which young, newly infected patients, mainly MSM, represent an unaware source of HIV-1 strains, continuously evolving during transmission, with drug susceptibility profiles that may become unpredictable.