Tenofovir Based Regimens Associated with Less Drug Resistance in HIV-1 Infected Nigerians Failing First-Line Antiretroviral Therapy
| Autor: | Mary Ann A. Etiebet, Man Charurat, Olufunmilayo Elegba, Samuel Ajayi, William A. Blattner, James Shepherd, Nicaise Ndembi, Lindsay M. Eyzaguirre, Alash'le Abimiku, Jean K. Carr, Harry Chang, Rebecca G. Nowak |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Genotype Immunology Mutation Missense Organophosphonates Nigeria Drug resistance Article Drug Administration Schedule Zidovudine Acquired immunodeficiency syndrome (AIDS) immune system diseases Internal medicine Drug Resistance Viral HIV Seropositivity Immunology and Allergy Medicine Humans Treatment Failure Tenofovir Retrospective Studies Reverse-transcriptase inhibitor business.industry Adenine virus diseases Odds ratio Viral Load Resistance mutation medicine.disease Virology Regimen Infectious Diseases Cross-Sectional Studies HIV-1 RNA Viral Reverse Transcriptase Inhibitors Female business Viral load medicine.drug |
| Popis: | Background: In resource-limited settings, HIV-1 drug resistance testing to guide antiretroviral therapy (ART) selection is unavailable. We retrospectively conducted genotypic analysis on archived samples from Nigerian patients who received targeted viral load testing to confirm treatment failure and report their drug resistance mutation patterns. Methods: Stored plasma from 349 adult patients on non-nucleoside reverse transcriptase inhibitor (NNRTI) regimens was assayed for HIV-1 RNA viral load, and samples with more than 1000copies/ml were sequenced in the pol gene. Analysis for resistance mutations utilized the IAS-US 2011 Drug Resistance Mutation list. Results: One hundred and seventy-five samples were genotyped; the majority of the subtypeswereG(42.9%)andCRF02_AG(33.7%).Patients wereonARTforamedianof 27 months. 90% had the M184V/I mutation, 62% had at least one thymidine analog mutation, and 14% had the K65R mutation. 97% had an NNRTI resistance mutation and 47% had at least two etravirine-associated mutations. In multivariate analysis tenofovir-based regimens were less likely to have at least three nucleoside reverse transcriptase inhibitor (NRTI) mutations after adjusting for subtype, previous ART, CD4, andHIV viralload [P |
| Databáze: | OpenAIRE |
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