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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Varied patterns of HIV-1 drug resistance on failing first-line antiretroviral therapy in South Africa
Journal of Acquired Immune Deficiency Syndromes, Volume 53, No. 4, Year 2010
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Description
BACKGROUND: The South African national antiretroviral therapy roll-out program is entering its sixth year, with over 570,000 adults accessing treatment. HIV-1 drug resistance is a potential consequence of therapy. This study determined the pattern of HIV-1 drug resistance mutations after failure of first-line treatment regimens in South Africa. METHODS: Two hundred and twenty-six patients virologically failing first-line regimens were studied to determine resistance patterns. RESULTS: The most common reverse transcriptase mutation was M184V/I (72%; n = 163); 11% of patients (n = 25) had only nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations and 17% (n = 38) had no known resistance mutations. The K65R mutation was detected in 4%. The frequency of thymidine analog mutations was significantly higher with azidothymidine-containing (31 of 57) than stavudine-containing regimens (39 of 169; P < 0.001). The Y181C mutation was more frequent with failure of nevirapine (NVP)-containing (26%) than efavirenz (EFV)-containing therapy (3%; P < 0.001). The V106M mutation was more frequent with EFV (30%) than NVP (4%; P = 0.012). CONCLUSIONS: HIV-1 drug resistance patterns varied broadly after failure of first-line therapy, ranging from no known resistance mutations (17%) to multinucleoside reverse transcriptase inhibitor and NNRTI resistance (23%). NNRTI mutation profiles differed for patients on EFV-compared with NVP-containing regimens. Overall, these findings suggest that HIV-1 drug resistance testing would be useful in identifying most appropriate second-line regimens. Copyright © 2010 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Wallis, Carole Lorraine
South Africa, Johannesburg
University of the Witwatersrand
Mellors, John W.
United States, Pittsburgh
University of Pittsburgh
Venter, Willem Daniel François
South Africa, Johannesburg
University of the Witwatersrand
Sanne, Ian
South Africa, Johannesburg
University of the Witwatersrand
Stevens, Wendy Susan
South Africa, Johannesburg
University of the Witwatersrand
South Africa, Johannesburg
National Health Laboratory Service
Statistics
Citations: 130
Authors: 5
Affiliations: 3
Identifiers
Doi:
10.1097/QAI.0b013e3181bc478b
ISSN:
15254135
Research Areas
Cancer
Infectious Diseases
Study Locations
South Africa