학술논문
Low levels of HIV-1 drug resistance mutations in patients who achieved viral re-suppression without regimen switch: a retrospective study.
Document Type
Article
Author
Onwuamah, Chika K.; Okpokwu, Jonathan; Audu, Rosemary; Imade, Godwin; Meloni, Seema T.; Okwuraiwe, Azuka; Chebu, Philippe; Musa, Adesola Z.; Chaplin, Beth; Dalhatu, Ibrahim; Agbaji, Oche; Samuels, Jay; Ezechi, Oliver; Ahmed, Mukhtar; Odaibo, Georgina; Olaleye, David O.; Okonkwo, Prosper; Salako, Babatunde Lawal; Raizes, Elliot; Yang, Chunfu
Source
Subject
*DRUG resistance
*PATIENT compliance
*ANTIRETROVIRAL agents
*VIRAL load
*RETROSPECTIVE studies
*RALTEGRAVIR
*
*
*
*
*
Language
ISSN
1471-2180
Abstract
Background: We identified a HIV-positive cohort in virologic failure (VF) who re-suppressed without drug switch. We characterized their drug resistance mutations (DRM) and adherence profiles to learn how to better manage HIV drug resistance. A retrospective cohort study utilizing clinical data and stored samples. Patients received ART at three Nigerian treatment centres. Plasma samples stored when they were in VF were genotyped. Result: Of 126 patients with samples available, 57 were successfully genotyped. From ART initiation, the proportion of patients with adherence ≥90% increased steadily from 54% at first high viral load (VL) to 67% at confirmed VF, and 81% at time of re-suppressed VL. Sixteen (28%) patients had at least one DRM. Forty-six (81%) patients had full susceptibility to the three drugs in their first-line (1 L) regimen. Thirteen (23%) were resistant to at least one antiretroviral drug but three were resistant to drugs not used in Nigeria. Ten patients had resistance to their 1 L drug(s) and six were fully susceptible to the three drugs in the recommended second-line regimen. Conclusion: This cohort had little drug resistance mutations. We conclude that if adherence is not assured, patients could exhibit virologic failure without having developed mutations associated with drug resistance. [ABSTRACT FROM AUTHOR]