1. HIV Drug Resistance Mutations in Non-B Subtypes After Prolonged Virological Failure on NNRTI-Based First-Line Regimens in Sub-Saharan Africa
- Author
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Peter Mugyenyi, Immaculate Nankya, A. Sarah Walker, C Warambwa, Philippa Easterbrook, Cissy Kityo, Emmanuel Ndashimye, Anne Hoppe, Ivan Mambule, Jennifer Thompson, Kara Wools-Kaloustian, Joep J. van Oosterhout, Nicholas I. Paton, and Silvia Bertagnolio
- Subjects
0301 basic medicine ,Adult ,Male ,Anti-HIV Agents ,030106 microbiology ,Etravirine ,HIV Infections ,Drug resistance ,non-B subtype ,03 medical and health sciences ,chemistry.chemical_compound ,Zidovudine ,0302 clinical medicine ,Abacavir ,Antiretroviral Therapy, Highly Active ,Drug Resistance, Viral ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Treatment Failure ,drug resistance mutations ,Africa South of the Sahara ,drug resistance ,Reverse-transcriptase inhibitor ,business.industry ,first-line failure ,virus diseases ,HIV ,Middle Aged ,Viral Load ,Clinical Science ,Virology ,HIV Reverse Transcriptase ,3. Good health ,CD4 Lymphocyte Count ,Infectious Diseases ,chemistry ,Rilpivirine ,Mutation ,Africa ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,HIV-1 ,Reverse Transcriptase Inhibitors ,Female ,business ,Viral load ,HIV drug resistance ,medicine.drug - Abstract
Supplemental Digital Content is Available in the Text., Objective: To determine drug resistance mutation (DRM) patterns in a large cohort of patients failing nonnucleoside reverse transcriptase inhibitor (NNRTI)-based first-line antiretroviral therapy regimens in programs without routine viral load (VL) monitoring and to examine intersubtype differences in DRMs. Design: Sequences from 787 adults/adolescents who failed an NNRTI-based first-line regimen in 13 clinics in Uganda, Kenya, Zimbabwe, and Malawi were analyzed. Multivariable logistic regression was used to determine the association between specific DRMs and Stanford intermediate-/high-level resistance and factors including REGA subtype, first-line antiretroviral therapy drugs, CD4, and VL at failure. Results: The median first-line treatment duration was 4 years (interquartile range 30–43 months); 42% of participants had VL ≥100,000 copies/mL and 63% participants had CD4
- Published
- 2017