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AutorWallis, Carole L.
AutorHughes, Michael D.
AutorRitz, Justin
AutorViana, Raquel
AutorJesus, Carlos Silva de
AutorSaravanan, Shanmugam
AutorSchalkwyk, Marije van
AutorMngqibisa, Rosie
AutorSalata, Robert
AutorMugyenyi, Peter
AutorHogg, Evelyn
AutorHovind, Laura
AutorWieclaw, Linda
AutorGross, Robert
AutorGodfrey, Catherine
AutorCollier, Ann C.
AutorGrinsztejn, Beatriz
AutorMellors, John W.
Fecha de acceso2020-11-27T00:07:48Z
Fecha de disponibilización2020-11-27T00:07:48Z
Fecha de publicación2020
ReferenciaWALLIS, Carole L. et al. Diverse Human Immunodeficiency Virus-1 Drug Resistance Profiles at Screening for ACTG A5288: A Study of People Experiencing Virologic Failure on Second-line Antiretroviral Therapy in Resource-limited Settings. Clinical Infectious Diseases, v. 71, n. 7, p. 170-177, 2020.pt_BR
ISSN1058-4838pt_BR
URIhttps://www.arca.fiocruz.br/handle/icict/44658
Idiomaengpt_BR
EditorOxfordpt_BR
Derechos de autorrestricted accesspt_BR
TítuloDiverse HIV-1 Drug Resistance Profiles at Screening for ACTG A5288: A Study of People Experiencing Virologic Failure on Second-line ART in Resource Limited Settingspt_BR
Tipo del documentoArticle
DOI10.1093/cid/ciz1116
Resumen en InglésBackground: Human immunodeficiency virus (HIV) drug resistance profiles are needed to optimize individual patient management and to develop treatment guidelines. Resistance profiles are not well defined among individuals on failing second-line antiretroviral therapy (ART) in low- and middle-income countries (LMIC). Methods: Resistance genotypes were performed during screening for enrollment into a trial of third-line ART (AIDS Clinical Trials Group protocol 5288). Prior exposure to both nucleoside reverse transcriptase inhibitors (NRTIs) and non-NRTIs and confirmed virologic failure on a protease inhibitor-containing regimen were required. Associations of drug resistance with sex, age, treatment history, plasma HIV RNA, nadir CD4+T-cell count, HIV subtype, and country were investigated. Results: Plasma HIV genotypes were analyzed for 653 screened candidates; most had resistance (508 of 653; 78%) to 1 or more drugs. Genotypes from 133 (20%) showed resistance to at least 1 drug in a drug class, from 206 (32%) showed resistance to at least 1 drug in 2 drug classes, and from 169 (26%) showed resistance to at least 1 drug in all 3 commonly available drug classes. Susceptibility to at least 1 second-line regimen was preserved in 59%, as were susceptibility to etravirine (78%) and darunavir/ritonavir (97%). Susceptibility to a second-line regimen was significantly higher among women, younger individuals, those with higher nadir CD4+ T-cell counts, and those who had received lopinavir/ritonavir, but was lower among prior nevirapine recipients. Conclusions: Highly divergent HIV drug resistance profiles were observed among candidates screened for third-line ART in LMIC, ranging from no resistance to resistance to 3 drug classes. These findings underscore the need for access to resistance testing and newer antiretrovirals for the optimal management of third-line ART in LMIC.pt_BR
AfiliaciónBio Analytical Research Corporation South Africa and Lancet Laboratories. Johannesburg, South Africa.pt_BR
AfiliaciónHarvard TH Chan School of Public Health. Boston, Massachusetts, USA.pt_BR
AfiliaciónHarvard TH Chan School of Public Health. Boston, Massachusetts, USA.pt_BR
AfiliaciónBio Analytical Research Corporation South Africa and Lancet Laboratories. Johannesburg, South Africa.pt_BR
AfiliaciónFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.pt_BR
AfiliaciónY.R. Gaitonde Centre for AIDS Research and Education. Chennai, India.pt_BR
AfiliaciónStellenbosch University. Family Clinical Research Unit Clinical Research Site. Cape Town, South Africa.pt_BR
AfiliaciónEnhancing Care Foundation. Durban Adult Human Immunodeficiency Virus Clinical Research Site. Durban, South Africa.pt_BR
AfiliaciónCase Western Reserve University. Department of Medicine. Cleveland, Ohio, USA.pt_BR
AfiliaciónJoint Clinical Research Center. Kampala, Uganda.pt_BR
AfiliaciónSocial and Scientific Systems. Silver Spring, Maryland, USA.pt_BR
AfiliaciónFrontier Science & Technology Research Foundation. Amherst, New York, USA.pt_BR
AfiliaciónFrontier Science & Technology Research Foundation. Amherst, New York, USA.pt_BR
AfiliaciónUniversity of Pennsylvania. Philadelphia, Pennsylvania, USA.pt_BR
AfiliaciónNational Institutes of Health. National Institute of Allergy and Infectious Diseases. Division of Acquired Immunodeficiency Syndrome. Bethesda, Maryland, USA.pt_BR
AfiliaciónUniversity of Washington. School of Medicine. Seattle, Washington, USA.pt_BR
AfiliaciónFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.pt_BR
AfiliaciónUniversity of Pittsburgh. School of Medicine. Department of Medicine. Division of Infectious Diseases. Pittsburgh, Pennsylvania, USA.pt_BR
Palavras clave en InglêsHIV-1 drug resistancept_BR
Palavras clave en InglêsNon-subtype Bpt_BR
Palavras clave en InglêsResource-limited settingpt_BR
Palavras clave en InglêsSecond-line ART failurept_BR


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