| Author | Kantor, Rami | |
| Author | Smeaton, Laura | |
| Author | Vardhanabhuti, Saran | |
| Author | Hudelson, Sarah E. | |
| Author | Wallis, Carol L. | |
| Author | Tripathy, Srikanth | |
| Author | Morgado, Mariza G. | |
| Author | Saravanan, Shanmugham | |
| Author | Balakrishnan, Pachamuthu | |
| Author | Reitsma, Marissa | |
| Author | Hart, Stephen | |
| Author | Mellors, John W. | |
| Author | Halvas, Elias | |
| Author | Grinsztejn, Beatriz | |
| Author | Hosseinipour, Mina C. | |
| Author | Kumwenda, Johnstone | |
| Author | La Rosa, Alberto | |
| Author | Lalloo, Umesh G. | |
| Author | Lama, Javier R. | |
| Author | Rassool, Mohammed | |
| Author | Santos, Breno R. | |
| Author | Supparatpinyo, Khuanchai | |
| Author | Hakim, James | |
| Author | Flanigan, Timothy | |
| Author | Kumarasamy, Nagalingeswaran | |
| Author | Campbell, Thomas B. | |
| Author | Eshleman, Susan H. | |
| Access date | 2016-07-14T12:28:09Z | |
| Available date | 2016-07-14T12:28:09Z | |
| Document date | 2015 | |
| Citation | KANTOR, Rami et al. Pretreatment HIV Drug Resistance and HIV-1 Subtype C Are Independently Associated With Virologic Failure: Results From the Multinational PEARLS (ACTG A5175) Clinical Trial. Clinical Infectious Diseases, v. 60, n. 10, p. 1541–1549, May 2015. | pt_BR |
| ISSN | 1058-4838 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/14873 | |
| Sponsorship | This work was supported by the Statistical and Data Management Center of the ACTG, under the NIAID (grant number UM1 AI068634) and the Leadership grant (grant number UM1AI068636); and the NIAID (grant numbers RO1AI066922 and P30AI042853 to R. K. and UM1AI068613 to S. H. E.). The pharmaceutical sponsors for this study included Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, and GlaxoSmithKline. | |
| Language | eng | pt_BR |
| Publisher | Oxford | pt_BR |
| Rights | restricted access | |
| Subject in Portuguese | HIV | pt_BR |
| Subject in Portuguese | Resistência à medicamentos | pt_BR |
| Subject in Portuguese | Subtipo | pt_BR |
| Subject in Portuguese | Ensaio Clínico | pt_BR |
| Title | Pretreatment HIV Drug Resistance and HIV-1 Subtype C Are Independently Associated With Virologic Failure: Results From the Multinational PEARLS (ACTG A5175) Clinical Trial | pt_BR |
| Type | Article | |
| DOI | 10.1093/cid/civ102 | |
| Abstract | Background: Evaluation of pretreatment HIV genotyping is needed globally to guide treatment programs. We examined the association of pretreatment (baseline) drug resistance and subtype with virologic failure in a multinational, randomized clinical trial that evaluated 3 antiretroviral treatment (ART) regimens and included resource-limited setting sites. Methods: Pol genotyping was performed in a nested case-cohort study including 270 randomly sampled participants (subcohort), and 218 additional participants failing ART (case group). Failure was defined as confirmed viral load (VL) >1000 copies/mL. Cox proportional hazards models estimated resistance-failure association. Results: In the representative subcohort (261/270 participants with genotypes; 44% women; median age, 35 years; median CD4 cell count, 151 cells/µL; median VL, 5.0 log10 copies/mL; 58% non-B subtypes), baseline resistance occurred in 4.2%, evenly distributed among treatment arms and subtypes. In the subcohort and case groups combined (466/488 participants with genotypes), used to examine the association between resistance and treatment failure, baseline resistance occurred in 7.1% (9.4% with failure, 4.3% without). Baseline resistance was significantly associated with shorter time to virologic failure (hazard ratio [HR], 2.03; P = .035), and after adjusting for sex, treatment arm, sex-treatment arm interaction, pretreatment CD4 cell count, baseline VL, and subtype, was still independently associated (HR, 2.1; P = .05). Compared with subtype B, subtype C infection was associated with higher failure risk (HR, 1.57; 95% confidence interval [CI], 1.04-2.35), whereas non-B/C subtype infection was associated with longer time to failure (HR, 0.47; 95% CI, .22-.98). Conclusions: In this global clinical trial, pretreatment resistance and HIV-1 subtype were independently associated with virologic failure. Pretreatment genotyping should be considered whenever feasible. | pt_BR |
| Affilliation | Brown University. Department of Medicine. Division of Infectious Diseases. Providence, Rhode Island, USA. | pt_BR |
| Affilliation | Harvard University, Boston. Harvard School of Public Health. Center for Biostatistics in AIDS Research. Boston, Massachusetts, USA. | pt_BR |
| Affilliation | Harvard University, Boston. Harvard School of Public Health. Center for Biostatistics in AIDS Research. Boston, Massachusetts, USA. | pt_BR |
| Affilliation | Johns Hopkins University School of Medicine. Department of Pathology. Baltimore, Maryland, USA. | pt_BR |
| Affilliation | Lancet Laboratories. Johannesburg, South Africa. | pt_BR |
| Affilliation | National AIDS Research Institute. Pune, India. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | YRG-CARE. Chennai, India. | pt_BR |
| Affilliation | YRG-CARE. Chennai, India. | pt_BR |
| Affilliation | Brown University. Department of Medicine. Division of Infectious Diseases. Providence, Rhode Island, USA. | pt_BR |
| Affilliation | Frontier Science and Technology Research Foundatio. Amherst, New York, USA. | pt_BR |
| Affilliation | University of Pittsburgh. Department of Medicine. Division of Infectious Diseases. Pittsburgh, Pennsylvania, USA. | pt_BR |
| Affilliation | University of Pittsburgh. Department of Medicine. Division of Infectious Diseases. Pittsburgh, Pennsylvania, USA. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | University of North Carolina Project–Malawi. Lilongwe. North Carolina, USA. | pt_BR |
| Affilliation | University of Malawi. College of Medicine. Department of Internal Medicine. Blantyre, Malawi. | pt_BR |
| Affilliation | Asociacion Civil Impacta Salud y Educacion. Barranco, Lima, Peru. | pt_BR |
| Affilliation | Enhancing Care Foundation. Durban, South Africa. | pt_BR |
| Affilliation | Asociacion Civil Impacta Salud y Educacion. Barranco, Lima, Peru. | pt_BR |
| Affilliation | University of Witwatersrand. Helen Joseph Hospital. Department of Medicine. Themba Lethu Clinic. Johannesburg, South Africa. | pt_BR |
| Affilliation | Hospital Nossa Senhora da Conceição. Serviço de Infectologia. Porto Alegre, RS, Brasil. | pt_BR |
| Affilliation | Chiang Mai University. Faculty of Medicine. Research Institute for Health Sciences. Thailand. | pt_BR |
| Affilliation | University of Zimbabwe. Department of Medicine. Harare, Zimbabwe. | pt_BR |
| Affilliation | Brown University. Department of Medicine. Division of Infectious Diseases. Providence, Rhode Island, USA. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | University of Colorado Denver. Department of Medicine. Division of Infectious Diseases. Aurora, USA. | pt_BR |
| Affilliation | Johns Hopkins University School of Medicine. Department of Pathology. Baltimore, Maryland, USA. | pt_BR |
| Subject | HIV | pt_BR |
| Subject | Drug resistance | pt_BR |
| Subject | Subtype | pt_BR |
| Subject | Clinical trial | pt_BR |
| e-ISSN | 1537-6591 | |
| Embargo date | 2030-12-31 | |
| xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar | |
