Patterns of emergent resistance-associated mutations after initiation of non-nucleoside reverse-transcriptase inhibitor-containing antiretroviral regimens in Taiwan: a multicenter cohort study

Chien-Yu Cheng,1,2 Mao-Song Tsai,3 Chia-Jui Yang,3,4 Shu-Hsing Cheng,1,5 Hsin-Yun Sun,6 Shu-Fang Chang,7 Li-Hsin Su,7 Yi-Ching Su,6 Chien-Ching Hung,6,8–10 Sui-Yuan Chang7,11 For the Taiwan HIV Study Group 1Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan; 2School of Public Health, National Yang-Ming University, Taipei, Taiwan; 3Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; 4School of Medicine, National Yang-Ming University, Taipei, Taiwan; 5School of Public Health, Taipei Medical University, Taipei, Taiwan; 6Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; 7Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan; 8Department of Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan; 9Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; 10China Medical University, Taichung, Taiwan; 11Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan Background: Increasing trends of resistance-associated mutations (RAMs) to non-nucleoside reverse-transcriptase inhibitors (nNRTIs) have raised concerns about the effectiveness of the regimens in the national HIV treatment programs in resource-limited countries. We aimed to retrospectively investigate the incidence and patterns of emergent RAMs of HIV-1 in HIV-positive adults experiencing virological failure to first-line nNRTI-containing combination antiretroviral therapy (cART) in Taiwan. Patients and methods: Between June 2012 and March 2016, 1138 antiretroviral-naïve HIV-positive adults without baseline RAMs who initiated nNRTI-containing regimens were included for analysis. Virological failure was defined as plasma viral load (PVL) ≥200copies/mL after 6months of cART or confirmed PVL ≥200copies/mL after achieving PVL