دورية أكاديمية
Protease Inhibitor Resistance in the First 3 Years of Second-Line Antiretroviral Therapy for HIV-1 in Sub-Saharan Africa.
| العنوان: | Protease Inhibitor Resistance in the First 3 Years of Second-Line Antiretroviral Therapy for HIV-1 in Sub-Saharan Africa. |
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| المؤلفون: | Boender TS; Amsterdam Institute for Global Health and Development, Department of Global Health., Hamers RL; Amsterdam Institute for Global Health and Development, Department of Global Health Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, University of Amsterdam, The Netherlands., Ondoa P; Amsterdam Institute for Global Health and Development, Department of Global Health., Wellington M; Newlands Clinic, Harare, Zimbabwe., Chimbetete C; Newlands Clinic, Harare, Zimbabwe., Siwale M; Lusaka Trust Hospital., Labib Maksimos EE; Coptic Hospital, Lusaka, Zambia., Balinda SN; Joint Clinical Research Centre, Kampala, Uganda., Kityo CM; Joint Clinical Research Centre, Kampala, Uganda., Adeyemo TA; Department of Haematology & Blood transfusion, College of Medicine of the University of Lagos, Nigeria., Akanmu AS; Department of Haematology & Blood transfusion, College of Medicine of the University of Lagos, Nigeria., Mandaliya K; Coast Province General Hospital, Mombasa, Kenya., Botes ME; Muelmed Hospital, Pretoria., Stevens W; Department of Molecular Medicine and Haematology, University of the Witwatersrand, and the National Health Laboratory Service, Johannesburg, South Africa., Rinke de Wit TF; Amsterdam Institute for Global Health and Development, Department of Global Health., Sigaloff KC; Amsterdam Institute for Global Health and Development, Department of Global Health Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, University of Amsterdam, The Netherlands. |
| المصدر: | The Journal of infectious diseases [J Infect Dis] 2016 Sep 15; Vol. 214 (6), pp. 873-83. Date of Electronic Publication: 2016 Jul 11. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 0413675 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1537-6613 (Electronic) Linking ISSN: 00221899 NLM ISO Abbreviation: J Infect Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Jan. 2011- : Oxford : Oxford University Press Original Publication: 1904-2010 : Chicago, IL : University of Chicago Press |
| مواضيع طبية MeSH: | Drug Resistance, Viral*, Anti-Retroviral Agents/*therapeutic use , HIV Infections/*drug therapy , HIV Infections/*virology , HIV Protease Inhibitors/*pharmacology , HIV-1/*drug effects, Adolescent ; Adult ; Africa South of the Sahara/epidemiology ; Female ; HIV Infections/epidemiology ; HIV-1/isolation & purification ; Humans ; Male ; Middle Aged ; Mutation ; Prevalence ; Prospective Studies ; Young Adult |
| مستخلص: | Background: As antiretroviral therapy (ART) programs in sub-Saharan Africa mature, increasing numbers of persons with human immunodeficiency virus (HIV) infection will experience treatment failure, and require second- or third-line ART. Data on second-line failure and development of protease inhibitor (PI) resistance in sub-Saharan Africa are scarce. Methods: HIV-1-infected adults were included if they received >180 days of PI-based second-line ART. We assessed risk factors for having a detectable viral load (VL, ≥400 cps/mL) using Cox models. If VL was ≥1000 cps/mL, genotyping was performed. Results: Of 227 included participants, 14.6%, 15.2% and 11.1% had VLs ≥400 cps/mL at 12, 24, and 36 months, respectively. Risk factors for a detectable VL were as follows: exposure to nonstandard nonnucleoside reverse-transcriptase inhibitor (NNRTI)-based (hazard ratio, 7.10; 95% confidence interval, 3.40-14.83; P < .001) or PI-based (7.59; 3.02-19.07; P = .001) first-line regimen compared with zidovudine/lamivudine/NNRTI, PI resistance at switch (6.69; 2.49-17.98; P < .001), and suboptimal adherence (3.05; 1.71-5.42; P = .025). Among participants with VLs ≥1000 cps/mL, 22 of 32 (69%) harbored drug resistance mutation(s), and 7 of 32 (22%) harbored PI resistance. Conclusions: Although VL suppression rates were high, PI resistance was detected in 22% of participants with VLs ≥1000 cps/mL. To ensure long-term ART success, intensified support for adherence, VL and drug resistance testing, and third-line drugs will be necessary. (© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.) |
| فهرسة مساهمة: | Keywords: HIV-1; drug resistance; protease inhibitor; second-line antiretroviral therapy; sub-Saharan Africa |
| المشرفين على المادة: | 0 (Anti-Retroviral Agents) 0 (HIV Protease Inhibitors) |
| تواريخ الأحداث: | Date Created: 20160713 Date Completed: 20170522 Latest Revision: 20220317 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1093/infdis/jiw219 |
| PMID: | 27402780 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1537-6613 |
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| DOI: | 10.1093/infdis/jiw219 |