Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Characterization of HIV-1 antiretroviral drug resistance after second-line treatment failure in Mali, a limited-resources setting
Journal of Antimicrobial Chemotherapy, Volume 67, No. 12, Article dks310, Year 2012
Notification
URL copied to clipboard!
Description
Objectives: We describe the outcomes of second-line drug resistance profiles and predict the efficacy of drugs for third-line therapy in patients monitored without the benefit of plasma HIV-1 RNA viral load (VL) or resistance testing. Methods: We recruited 106 HIV-1-infected patients after second-line treatment failure in Mali. VL was determined by the Abbott RealTime system and the resistance by the ViroSeq HIV-1 genotyping system. The resistance testing was interpreted using the latest version of the Stanford algorithm. Results: Among the 106 patients, 93 had isolates successfully sequenced. The median age, VL and CD4 cells were respectively 35 years, 72 000 copies/mL and 146 cells/mm3. Patients were exposed to a median of 4 years of treatment and to six antiretrovirals. We found 20% of wild-type viruses. Resistance to etravirine was noted in 38%, to lopinavir in 25% and to darunavir in 12%. The duration of prior nucleos(t)ide reverse transcriptase inhibitor exposure was associated with resistance to abacavir (P < 0.0001) and tenofovir (P = 0.0001), and duration of prior protease inhibitor treatment with resistance to lopinavir (P < 0.0001) and darunavir (P = 0.06). Conclusion: Long duration of therapy prior to failure was associated with high levels of resistance and is directly related to limited access to VL monitoring and delayed switches to second-line treatment, precluding efficacy of drugs for third-line therapy. This study underlines the need for governments and public health organizations to recommend the use of VL monitoring and also the availability of darunavir and raltegravir for third-line therapies in the context of limited-resource settings. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Authors & Co-Authors
Maïga, Almoustapha Issiaka
Mali, Bamako
University Clinical Research Center Ucrc-serefo Laboratory, University of Sciences, Techniques and Technologies of Bamako Usttb
Fofana, Djeneba Bocar
Mali, Bamako
University Clinical Research Center Ucrc-serefo Laboratory, University of Sciences, Techniques and Technologies of Bamako Usttb
France, Paris
Ap-hp Assistance Publique - Hopitaux de Paris
Cissé, Mamadou C.
Mali, Bamako
Cesac
Diallo, Fodié B.
Mali, Bamako
Usac Commune I
Maïga, Moussa Youssouffa
Mali, Bamako
Chu Gabriel-touré
Traoré, Hammar Alassane
Mali, Bamako
Chu du Point g
Maïga, Issouf Alassane
Mali, Bamako
Esther
Sylla, Aliou O.
Mali, Bamako
Cellule Sectorielle de Lutte Contre le Sida
Fofana, Dionke
France, Paris
Esther
Taiwo, Babafemi Olapoju
United States, Evanston
Northwestern University
Murphy, Robert L.
United States, Evanston
Northwestern University
Katlama, Christine
France, Paris
Ap-hp Assistance Publique - Hopitaux de Paris
Tounkara, Anatole
Mali, Bamako
University Clinical Research Center Ucrc-serefo Laboratory, University of Sciences, Techniques and Technologies of Bamako Usttb
Calvez, Vincent
France, Paris
Ap-hp Assistance Publique - Hopitaux de Paris
Marcelin, Anne Geneviève
France, Paris
Ap-hp Assistance Publique - Hopitaux de Paris
Statistics
Citations: 37
Authors: 15
Affiliations: 10
Identifiers
Doi:
10.1093/jac/dks310
ISSN:
03057453
e-ISSN:
14602091
Research Areas
Cancer
Health System And Policy
Infectious Diseases
Study Locations
Mali