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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Limited clinical benefit of minority K103N and Y181C-variant detection in addition to routine genotypic resistance testing in antiretroviral therapy-naive patients
AIDS, Volume 28, No. 15, Year 2014
Notification
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Description
Objective: The presence of minority nonnucleoside reverse transcriptase inhibitor (NNRTI)-resistant HIV-1 variants prior to antiretroviral therapy (ART) has been linked to virologic failure in treatment-naive patients. Design: We performed a large retrospective study to determine the number of treatment failures that could have been prevented by implementing minority drug-resistant HIV-1 variant analyses in ART-naýve patients in whom no NNRTI resistance mutations were detected by routine resistance testing. Methods: Of 1608 patients in the Swiss HIV Cohort Study, who have initiated first-line ART with two nucleoside reverse transcriptase inhibitors (NRTIs) and one NNRTI before July 2008, 519 patients were eligible by means of HIV-1 subtype, viral load and sample availability. Key NNRTI drug resistance mutations K103N and Y181C were measured by allele-specific PCR in 208 of 519 randomly chosen patients. Results: Minority K103N and Y181C drug resistance mutations were detected in five out of 190 (2.6%) and 10 out of 201 (5%) patients, respectively. Focusing on 183 patients for whom virologic success or failure could be examined, virologic failure occurred in seven out of 183 (3.8%) patients; minority K103N and/or Y181C variants were present prior to ART initiation in only two of those patients. The NNRTI-containing, first-line ART was effective in 10 patients with preexisting minority NNRTI-resistant HIV-1 variant. Conclusion: As revealed in settings of case-control studies, minority NNRTI-resistant HIV-1 variants can have an impact on ART. However, the implementation of minority NNRTI-resistant HIV-1 variant analysis in addition to genotypic resistance testing (GRT) cannot be recommended in routine clinical settings. Additional associated risk factors need to be discovered. © 2014 Wolters Kluwer Health-Lippincott Williams & Wilkins.
Authors & Co-Authors
Metzner, Karin Jutta
Switzerland, Zurich
Universitatsspital Zurich
Scherrer, Alexandra U.
Switzerland, Zurich
Universitatsspital Zurich
von Wyl, Viktor
Switzerland, Zurich
Universitatsspital Zurich
Böni, Jürg
Switzerland, Zurich
Universität Zürich
Yerly, Sabine T.B.D.
Switzerland, Geneva
Unaids
Klimkait, Thomas
Switzerland, Basel
Universitat Basel
Aubert, Vincent
Switzerland, Lausanne
Centre Hospitalier Universitaire Vaudois
Furrer, Hansjakob Jackob
Switzerland, Bern
University Hospital Bern
Hirsch, Hans H.
Switzerland, Basel
Universitätsspital Basel
Vernazza, Pietro Luigi
Switzerland, St Gallen
Kantonsspital St.gallen
Cavassini, Matthias L.
Switzerland, Lausanne
Centre Hospitalier Universitaire Vaudois
Calmy, Alexandra L.
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Bernasconi, Enos
Switzerland, Bellinzona
Ente Ospedaliero Cantonale
Weber, Rainer
Switzerland, Zurich
Universitatsspital Zurich
Günthard, Hüldrych Fritz
Switzerland, Zurich
Universitatsspital Zurich
Aubert, Vincent
Unknown Affiliation
Barth, Jürgen
Unknown Affiliation
Battegay, Manuel
Unknown Affiliation
Bernasconi, Enos
Unknown Affiliation
Böni, Jürg
Unknown Affiliation
Bucher, Heíner C.C.
Unknown Affiliation
Burton-Jeangros, Claudine
Unknown Affiliation
Calmy, Alexandra
Unknown Affiliation
Cavassini, Matthias
Unknown Affiliation
Egger, Matthias
Unknown Affiliation
Elzi, Luigia
Unknown Affiliation
Fehr, Jan Sven
Unknown Affiliation
Fellay, Jacques
Unknown Affiliation
Francioli, Patrick B.
Unknown Affiliation
Furrer, Hansjakob
Unknown Affiliation
Fux, Christoph Andreas
Switzerland
Shcs
Gorgievski, Meri
Switzerland
Shcs
Günthard, Huldrych F.
Switzerland
Shcs
Haerry, David Hans Ulrich
Unknown Affiliation
Hasse, Barbara Katharina
Unknown Affiliation
Hirschel, Bernard J.
Unknown Affiliation
Hösli, Irene Mathilde
Unknown Affiliation
Kahlert, Christian R.
Unknown Affiliation
Kaiser, Laurent K.
Unknown Affiliation
Keiser, Olivia
Unknown Affiliation
Kind, Christian H.
Unknown Affiliation
Kovari, Helen
Unknown Affiliation
Ledergerber, Bruno
Unknown Affiliation
Martinetti, Gladys
Unknown Affiliation
Martínez de Tejada, Begoῆa
Unknown Affiliation
Müller, Nicolas J.
Unknown Affiliation
Nadal, David
Unknown Affiliation
Pantaleo, Giuseppe P.
Unknown Affiliation
Rauch, Andri
Unknown Affiliation
Regenass, Stephan
Unknown Affiliation
Rickenbach, Martin
Unknown Affiliation
Rudin, Christoph
Unknown Affiliation
Schmid, Patrick
Unknown Affiliation
Schültze, Detlev
Unknown Affiliation
Schöni-Affolter, Franziska
Unknown Affiliation
Schüpbach, Jörg Rg
Unknown Affiliation
Speck, Roberto F.
Unknown Affiliation
Taffé, Patrick
Unknown Affiliation
Tarr, Philip E.
Unknown Affiliation
Telenti, Amalio
Unknown Affiliation
Trkola, Alexandra
Unknown Affiliation
Vernazza, Pietro L.
Unknown Affiliation
Statistics
Citations: 20
Authors: 62
Affiliations: 11
Identifiers
Doi:
10.1097/QAD.0000000000000397
ISSN:
02699370
Research Areas
Genetics And Genomics
Infectious Diseases
Study Design
Cohort Study
Case-Control Study
Study Approach
Quantitative