cris.boxmetadata.label.title
Antiretroviral resistance after first-line antiretroviral therapy failure in diverse HIV-1 subtypes in the SECOND-LINE study
cris.boxmetadata.label.dateissued
01 browse.startsWith.months.september 2016
cris.boxmetadata.label.accesslevel
open access
cris.boxmetadata.label.resourcetype
journal article
cris.boxmetadata.label.authors
Lam E.
Moore C.
GOTUZZO HERENCIA, JOSE EDUARDO
Nwizu C.
Kamarulzaman A.
Chetchotisakd P.
Van Wyk J.
Teppler H.
Kumarasamy N.
Molina J.
Emery S.
Cooper D.
Boyd M.
cris.boxmetadata.label.publisher
Mary Ann Liebert Inc.
cris.boxmetadata.label.abstract
We investigate mutations and correlates according to HIV-1 subtype after virological failure (VF) of standard first-line antiretroviral therapy (ART) (non-nucleoside/nucleotide reverse transcriptase inhibitor [NNRTI] +2 nucleoside/nucleotide reverse transcriptase inhibitor [N(t)RTI]). SECOND-LINE study participants were assessed at baseline for HIV-1 subtype, demographics, HIV-1 history, ART exposure, viral load (VL), CD4+ count, and genotypic ART resistance. We used backward stepwise multivariate regression (MVR) to assess associations between baseline variables and presence of ≥3 N(t)RTI mutations, ≥1 NNRTI mutation, ≥3 thymidine analog-N(t)RTI [ta-N(t)RTI] mutations (TAMs), the K65/K70 mutation, and predicted etravirine (ETV)/rilpivirine (RPV) activity. The inclusion p-value for MVR was p < .2. The exclusion p-value from stepwise elimination was p > .05. Of 541 participants, 491 (91%) had successfully characterized baseline viral isolates. Subtype distribution: B (n = 123, 25%), C (n = 202, 41%), CRF01-AE (n = 109, 22%), G (n = 25, 5%), and CRF02-AG (n = 27, 5%). Baseline CD4+ 200-394 cells/mm3 were associated with <3 N(t)RTI mutations (OR = 0.47; 95% CI 0.29-0.77; p = .003), absence of the K65/K70 mutation (OR = 0.43; 95% CI 0.26-0.73; p = .002), and higher ETV sensitivity (OR = 0.52; 95% CI 0.35-0.78; p = .002). Recent tenofovir (TDF) use was associated with K65/K70 mutations (OR = 8.91; 95% CI 5.00-15.85; p < .001). Subtype CRF01-AE was associated with ≥3 N(t)RTI mutations (OR = 2.34; 95% CI 1.31-4.17; p = .004) and higher RPV resistance (OR = 2.13; 95% CI 1.30-3.49; p = .003), and subtype C was associated with <3 TAMs (OR = 0.45; 95% CI 0.21-0.99; p = .015). Subtypes CRF01-AE (OR = 2.46; 95% CI 1.26-4.78; p = .008) and G (OR = 4.77; 95% CI 1.44-15.76; p = .01) were associated with K65/K70 mutations. Higher VL at confirmed first-line VF was associated with ≥3 N(t)RTI mutations (OR = 1.39; 95% CI 1.07-1.78; p = .013) and ≥3 TAMs (OR = 1.62; 95% CI 1.15-2.29; p = .006). The associations of first-line resistance mutations across the HIV-1 subtypes in this study are consistent with knowledge derived from subtype B, with some exceptions. Patterns of resistance after failure of a first-line ta-N(t)RTI regimen support using TDF in N(t)RTI-containing second-line regimens, or using N(t)RTI-sparing regimens.
cris.boxmetadata.label.citationstartpage
841
cris.boxmetadata.label.citationendpage
850
cris.boxmetadata.label.volume
32
cris.boxmetadata.label.issue
9
cris.boxmetadata.label.language
English
cris.boxmetadata.label.ocdeknowledgeArea
Virología
Farmacología, Farmacia
cris.boxmetadata.label.doi
cris.boxmetadata.label.scopusidentifier
2-s2.0-84984963163
cris.boxmetadata.label.pubmedidentifier
cris.boxmetadata.label.source
AIDS Research and Human Retroviruses
cris.boxmetadata.label.containerissn
08892229
peru-layout.shadow-copies
Directorio de Producción Científica
Scopus