HIV Drug Resistance in Adults Receiving Early vs. Delayed Antiretroviral Therapy: HPTN 052

Palumbo, Philip J.; Fogel, Jessica M.; Hudelson, Sarah E.; Wilson, Ethan; Hart, Stephen A.; Hovind, Laura; Piwowar‐Manning, Estelle; Wallis, Carole L.; Papathanasopoulos, Maria A.; Morgado, Mariza G.; Saravanan, S.; Tripathy, Srikanth; Eron, Joseph J.; Gallant, Joel E.; McCauley, Marybeth; Gamble, Theresa; Hosseinipour, Mina C.; Kumarasamy, Nagalingeswaran; Hakim, James; Pilotto, José Henrique; Kumwenda, Johnstone; Akelo, Victor; Godbole, Sheela; Grinsztejn, Beatriz; Panchia, Ravindre; Chariyalertsak, Suwat; Makhema, Joseph; Badal-Faesen, Sharlaa; Chen, Ying Qing; Cohen, Myron S.; Eshleman, Susan H.

doi:10.1097/qai.0000000000001623

Cited by 11 publications

(7 citation statements)

References 36 publications

(45 reference statements)

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“…As expected, nadir CD4 count ≥200 cells/mm 3 was a protective factor associated with HIV-MDR, whereas AIDS events were associated with higher risk of HIV-MDR. The negative association between higher nadir CD4 count and HIV-MDR suggests that subjects were more likely to start ART during the early phase of HIV infection, thus limiting the viral replication and in turn the frequency of newly acquired drug resistance [32]. Notably, in this study HCV seropositivity also seemed to be a protective factor associated with HIV-MDR.…”

Section: Discussionmentioning

confidence: 54%

Prevalence and factors associated with HIV-1 multi-drug resistance over the past two decades in the Italian ARCA database

Lombardi

Giacomelli

Armenia

et al. 2021

International Journal of Antimicrobial Agents

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Section: Discussionmentioning

confidence: 54%

Prevalence and factors associated with HIV-1 multi-drug resistance over the past two decades in the Italian ARCA database

Lombardi

Giacomelli

Armenia

et al. 2021

International Journal of Antimicrobial Agents

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“…An effective life-long drug adherence is required to achieve successful treatment. (4,8) Higher risk in developing DRM has been associated with low drug adherence. (9)(10)(11)(12) Drug resistance mutation is one of the major problems in ARV therapy management, especially in upscaling the ARV coverage program.…”

Section: Introductionmentioning

confidence: 99%

Viral load as a risk factor of reverse transcriptase inhibitor drug resistance mutation in antiretroviral-treated people living with HIV/AIDS

Hutapea¹,

Kridaningsih²,

Prasetyo³

et al. 2021

Universa Medicina

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Background The human immunodeficiency virus type 1 (HIV-1) is a major contagion faced by the population of Indonesia. The success of antiretroviral treatment (ART) is threatened by the emergence of drug resistance mutations (DRM). The aim of this study was to determine the association between CD4 count, CD4 count changes, viral load, adherence to therapy, and therapy history in the presence of DRM in people living with HIV/AIDS (PLWHA). MethodsThis was a cross-sectional study involving 269 adults who underwent antiretroviral (ARV) therapy for at least 6 months. The frequencies of DRM and polymorphisms were measured by partial amplification of the reverse transcriptase (RT) gene using RT-nested PCR on samples with viral loads of >1000 copies/mL. Sequencing was performed using the Sanger method, and edited by BioEdit. The edited sequences were submitted to http://hivdb.stanford.edu for DRM determination. Respondents’ medical data, CD4 count, viral load, and DRM were analyzed by simple and multiple logistic regression. ResultsThe multiple logistic regression analysis showed a significant association of CD4 count (aOR=12.47; 95% CI: 1.45 -107.39; p=0.023) and viral load at the time of study (aOR=29.56; 95% CI: 3.47-251.52; p=0.002) with the presence of DRM in respondents. ARV substitution history was not associated with the presence of DRM. There were 17 respondents (6.3%) carrying HIV-1 DRM, with M184V/I (11 sequences) as the most frequent pattern of NRTI resistance, and K103 (9 sequences) as that of NNRTI resistance. ConclusionThis study demonstrated that viral load at the time of the study was the most influential determinant factor for the presence of DRM in PLWHA.

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“…This is in line with previously reported findings from this cohort of similar short- and long-term ART outcomes with regard to TB co-infection [ 16 , 36 ]. Factors that have been associated with acquisition of DRMs in other studies include male sex, higher pretreatment VL, and lower CD4 counts [ 37–39 ]. Interestingly, although participants with TB were more likely to have these characteristics [ 18 ], they were not at increased risk of DRM acquisition.…”

Section: Discussionmentioning

confidence: 99%

Drug Resistance in HIV-Positive Adults During the Initial Year of Antiretroviral Treatment at Ethiopian Health Centers

Reepalu

Arimide

Balcha

et al. 2021

Open Forum Infectious Diseases

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Objectives The increasing prevalence of antiretroviral drug resistance in sub-Saharan Africa threatens the success of HIV programs. We have characterized patterns of drug resistance mutations (DRM) during the initial year of antiretroviral treatment (ART) in HIV-positive adults receiving care at Ethiopian health centers and investigated the impact of tuberculosis on DRM acquisition. Methods Participants were identified from a cohort of ART-naïve individuals aged ≥18 years, all of whom had been investigated for active tuberculosis at inclusion. Individuals with viral load (VL) data at 6 and/or 12 months after ART initiation were selected for this study. Genotypic testing was performed on samples with VL≥500 copies/mL obtained on these occasions, and on pre-ART samples from those with detectable DRM during ART. Logistic regression analysis was used to investigate the association between DRM acquisition and tuberculosis. Results Among 621 included individuals (110 [17.5%] with concomitant tuberculosis), 101/621 (16.3%) had VL≥500 copies/mL at 6 and/or 12 months. DRM were detected in 64/98 cases with successful genotyping (65.3%). DRM were detected in 7/56 (12.5%) pre-ART samples from these individuals. High pre-ART VL and low mid-upper arm circumference were associated with increased risk of DRM acquisition, whereas no such association was found for concomitant tuberculosis. Conclusions Among adults receiving health-center based ART in Ethiopia, most patients without virological suppression during the first year of ART had detectable DRM. Acquisition of DRM during this period was the dominant cause of antiretroviral drug resistance in this setting. Tuberculosis did not increase the risk of DRM acquisition.

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HIV Drug Resistance in Adults Receiving Early vs. Delayed Antiretroviral Therapy: HPTN 052

Abstract: In HPTN 052, the frequency of new drug resistance at virologic failure was lower in adults with early ART initiation. The main factor associated with reduced drug resistance with early ART was lower baseline viral load.

Cited by 11 publications

References 36 publications

Prevalence and factors associated with HIV-1 multi-drug resistance over the past two decades in the Italian ARCA database

Prevalence and factors associated with HIV-1 multi-drug resistance over the past two decades in the Italian ARCA database

Viral load as a risk factor of reverse transcriptase inhibitor drug resistance mutation in antiretroviral-treated people living with HIV/AIDS

Drug Resistance in HIV-Positive Adults During the Initial Year of Antiretroviral Treatment at Ethiopian Health Centers

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