HIV-1 drug resistance testing is essential for heavily-treated patients switching from first- to second-line regimens in resource-limited settings: evidence from routine clinical practice in Cameroon

Autor: Desire Takou, Joseph Fokam, Georges Teto, Maria-Mercedes Santoro, Francesca Ceccherini-Silberstein, Aubin Joseph Nanfack, Samuel Martin Sosso, Béatrice Dambaya, Romina Salpini, Serge Clotaire Billong, Caterina Gori, Charles Ntungwen Fokunang, Giulia Cappelli, Vittorio Colizzi, Carlo-Federico Perno, Alexis Ndjolo
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-9 (2019)
Druh dokumentu: article
ISSN: 1471-2334
DOI: 10.1186/s12879-019-3871-0
Popis: Abstract Background With the phase-out of stavudine (d4T), change to first-line regimens with zidovudine (AZT) or tenofovir (TDF) in resource-limited settings (RLS) might increase risks of cross-resistance to nucleos(t) ide reverse transcriptase inhibitors (NRTI). This would restrict the scope of switching to the World Health Organisation (WHO)-recommended standard second-line combinations (SLC) without HIV drug resistance (HIVDR)-testing in routine clinical practice. Methods An observational study was conducted among 101 Cameroonian patients (55.4% male, median [IQR] age 34 [10–41] years) failing first-line antiretroviral therapy (ART) in 2016, and stratified into three groups according to NRTIs exposure: exposure to both thymidine analogues AZT “and” D4T (group-A, n = 55); exposure to both TDF and AZT “or” D4T (group-B, n = 22); exposure solely to D4T (group-C, n = 24). Protease-reverse transcriptase HIVDR was interpreted using the HIVdb penalty scores (≥60: high-resistance; 20–59: intermediate-resistance;
Databáze: Directory of Open Access Journals
Externí odkaz: