Delayed identification of treatment failure causes high levels of acquired drug resistance and less future drug options among HIV-1-infected South Indians.

Autor: Sivamalar S; Meenakshi Academy of Higher Education and Research (Deemed to be University), West K. K. Nagar, Chennai, 600 078, India; YR Gaitonde Centre for AIDS Research and Education, Voluntary Health Services, Hospital Campus, Taramani, Chennai, 600 113, India., Gomathi S; YR Gaitonde Centre for AIDS Research and Education, Voluntary Health Services, Hospital Campus, Taramani, Chennai, 600 113, India., Boobalan J; YR Gaitonde Centre for AIDS Research and Education, Voluntary Health Services, Hospital Campus, Taramani, Chennai, 600 113, India., Balakrishnan P; Centre for Infectious Diseases Saveetha Medical College & Hospitals [SMCH], Saveetha Institute of Medical and Technical Sciences [SIMATS], Saveetha University, Thandalam, Chennai, 602105, India., Pradeep A; YR Gaitonde Centre for AIDS Research and Education, Voluntary Health Services, Hospital Campus, Taramani, Chennai, 600 113, India., Devaraj CA; YR Gaitonde Centre for AIDS Research and Education, Voluntary Health Services, Hospital Campus, Taramani, Chennai, 600 113, India., Solomonl SS; YR Gaitonde Centre for AIDS Research and Education, Voluntary Health Services, Hospital Campus, Taramani, Chennai, 600 113, India; Johns Hopkins University School of Medicine, Baltimore, MD, USA., Nallusamy D; Meenakshi Academy of Higher Education and Research (Deemed to be University), West K. K. Nagar, Chennai, 600 078, India., Nalini D; Meenakshi Academy of Higher Education and Research (Deemed to be University), West K. K. Nagar, Chennai, 600 078, India., Sureka V; Meenakshi Academy of Higher Education and Research (Deemed to be University), West K. K. Nagar, Chennai, 600 078, India., Saravanan S; Centre for Infectious Diseases Saveetha Medical College & Hospitals [SMCH], Saveetha Institute of Medical and Technical Sciences [SIMATS], Saveetha University, Thandalam, Chennai, 602105, India. Electronic address: drsara.svg@gmail.com.
Jazyk: angličtina
Zdroj: Indian journal of medical microbiology [Indian J Med Microbiol] 2024 Jan-Feb; Vol. 47, pp. 100520. Date of Electronic Publication: 2024 Jan 13.
DOI: 10.1016/j.ijmmb.2023.100520
Abstrakt: Purpose: HIV-1 Drug Resistance Mutations (DRMs) among Immunological failure (IF) on NRTI based first-line regimens, Thymidine analogue (TA) - AZT & D4T and Non-Thymidine Analogue (NTA) -TDF; and predict viral drug susceptibility to gain vision about optimal treatment strategies for second-line.
Methods: Cross-sectionally, 300 HIV-1 infected patients, failing first-line HAART were included. HIV-1 pol gene spanning 20-240 codons of RT was genotyped and mutation pattern was examined, (IAS-USA 2014 and Stanford HIV drug resistance database v7.0).
Results: The median age of the participants was 35 years (IQR 29-40), CD4 T cell count of TDF failures was low at 172 cells/μL (IQR 80-252), and treatment duration was low among TDF failures (24 months vs. 61 months) (p < 0.0001). Majority of the TDF failures were on EFV based first-line (89 % vs 45 %) (p < 0.0001). Level of resistance for TDF and AZT shows, that resistance to TDF was about one-third (37 %) of TDF participants and onefourth (23 %) of AZT participants; resistance to AZT was 17 % among TDF participants and 47 % among AZT participants; resistance to both AZT and TDF was significantly high among AZT participants [21 % vs. 8 %, OR 3.057 (95 % CI 1.4-6.8), p < 0.0001].
Conclusion: Although delayed identification of treatment failure caused high levels of acquired drug resistance in our study. Thus, we must include measures to regularize virological monitoring with integrated resistance testing in LMIC (Low and Middle Income Countries) like in India; this will help to preserve the effectiveness of ARV and ensure the success of ending AIDS as public health by 2030.
Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest.
(Copyright © 2023 Indian Association of Medical Microbiologists. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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