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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Prevalence of HIV-1 drug resistance after failure of a first highly active antiretroviral therapy regimen in KwaZulu Natal, South Africa
Clinical Infectious Diseases, Volume 46, No. 10, Year 2008
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Description
Background. Emergence of human immunodeficiency virus type 1 (HIV-1) drug resistance may limit the benefits of antiretroviral therapy in resource-limited settings. The prevalence of resistance was assessed among patients from KwaZulu Natal, South Africa, following failure of their first highly active antiretroviral therapy (HAART) regimen. Methods. Genotypic resistance testing was performed on plasma virus samples from patients who experienced virologic failure of their first HAART regimen at 2 clinics in KwaZulu Natal. Clinical and demographic data were obtained from medical records. Regression analysis was performed to determine factors associated with ≥1 significant drug resistance mutation. Results. From January 2005 through August 2006, a total of 124 antiretroviral-treated adults who experienced virologic failure were enrolled. The predominant subtype was HIV-1C. Virus samples from 83.5% of participants carried ≥1 significant drug resistance mutation. Dual-class drug-resistant virus was present in 64.3% of participants, and 2.6% had virus with triple-class drug resistance. The most common mutation was M184V/I (64.3% of patients); K103N was present in virus from 51.3%, and V106M was present in virus from 19.1%. Thymidine analog resistance mutations were found in virus from 32.2% of patients, and protease resistance mutations were found in virus from 4.4%. Conclusions. Antiretroviral drug-resistant virus was detected in >80% of South African patients who experienced failure of a first HAART regimen. Patterns of drug resistance reflected drugs used in first-line regimens and viral subtype. Continued surveillance of resistance patterns is warranted to guide selection of second-line regimens. © 2008 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Marconi, Vincent Charles
United States, Boston
Brigham and Women's Hospital
United States, San Antonio
Wilford Hall Ambulatory Surgical Center
Sunpath, Henry
South Africa, Durban
Mccord Hospital
Lu, Zhigang
United States, Boston
Massachusetts General Hospital
Gordon, Michelle L.
South Africa, Durban
Inkosi Albert Luthuli Central Hospital
Koranteng-Apeagyei, Kofi
South Africa, Cape Town
St. Mary's Hospital
Hampton, Jane
South Africa, Durban
Mccord Hospital
Carpenter, Steve
South Africa, Cape Town
St. Mary's Hospital
Giddy, Janet
South Africa, Durban
Mccord Hospital
Ross, Douglas S.
South Africa, Cape Town
St. Mary's Hospital
Holst, Helga
South Africa, Durban
Mccord Hospital
Losina, Elena
United States, Boston
Massachusetts General Hospital
Walker, Bruce D.
United States, Boston
Massachusetts General Hospital
United States, Boston
Harvard Medical School
United States, Chevy Chase
Howard Hughes Medical Institute
Kuritzkes, Daniel R.D.
United States, Boston
Brigham and Women's Hospital
United States, Boston
Harvard Medical School
Statistics
Citations: 264
Authors: 13
Affiliations: 8
Identifiers
Doi:
10.1086/587109
ISSN:
10584838
Research Areas
Cancer
Infectious Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
South Africa