Accumulation of HIV-1 Drug Resistance Mutations After First-Line Immunological Failure to Evaluate the Options of Recycling NRTI Drugs in Second-Line Treatment: A Study from South India
| Autor: | S. Poongulali, Pachamuthu Balakrishnan, Sunil S. Solomon, Ambrose Pradeep, Selvamurthi Gomathi, Shanmugam Saravanan, Suniti Solomon, Jayaseelan Boobalan, Sathasivam Sivamalar, Thongadi Ramesh Dinesha |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Drug Oncology Adult Male medicine.medical_specialty Anti-HIV Agents media_common.quotation_subject First line Immunology Mutation Missense India HIV Infections Drug resistance Evolution Molecular 03 medical and health sciences stomatognathic system Virology Internal medicine Drug Resistance Viral medicine Humans Longitudinal Studies Treatment Failure skin and connective tissue diseases media_common Second line treatment Reverse-transcriptase inhibitor business.industry Middle Aged Resistance mutation 030112 virology 030104 developmental biology Infectious Diseases Female business Viral load hormones hormone substitutes and hormone antagonists HIV drug resistance medicine.drug |
| Zdroj: | AIDS research and human retroviruses. 33(3) |
| ISSN: | 1931-8405 |
| Popis: | Lack of HIV-1 viral load monitoring in resource-limited settings leads to the development of HIV drug resistance mutations, although WHO recommends viral load testing for monitoring as this helps in preserving future treatment options and also avoid unnecessary switching to more expensive drugs. A total of 101 patients attaining first-line treatment failure (FTF) were followed until second-line treatment failure (STF) to study the rate of accumulation of thymidine analogue mutations (TAMs), their future drug options, and genetic evolution. The result shows that predominant nucleos(t)ide reverse transcriptase inhibitor (NRTI) mutations were M184V/I (87.3% in FTF and 79% in STF) followed by TAMs (53.4% in FTF and 54.5% in STF). The rate of accumulation of TAMs was higher for a patient with TAMI [0.015 TAM per person-month (TPPM)], TAMII (0.042 TPPM), and 1 (0.005 TPPM) or 2 TAMs (0.008 TPPM) compared with a patient with both TAMs and 3 or3 TAMs. Future ART options show that50% of the patients can be considered for choices to recycle NRTIs in the second-line, and third-line therapy. We conclude that the patients who initiated thymidine analogue-based first-line before 2010 can be very well opted for AZT- and TDF-based second-line regimen in the future. |
| Databáze: | OpenAIRE |
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