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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Low rate of genotypic HIV-1 drug-resistant strains in the Senegalese government initiative of access to antiretroviral therapy
AIDS, Volume 17, No. SUPPL. 3, Year 2003
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Description
Objective: To monitor the prevalence of antiretroviral (ARV)-resistant HIV-1 viruses, and the genotypic mutations in patients enrolled in the Senegalese initiative for access to antiretroviral treatment (ART). Methods: A total of 80 patients with a virological follow-up of at least 6 months were selected, 68 were ART-naive and 12 ART-experienced. Genotypic resistance to ARV was studied at baseline for a random subset of patients and at each rebound in plasma viral load during ART, by sequencing the protease and reverse transcriptase genes. Results: At baseline, 66 patients received highly active antiretroviral therapy (HAART) [2 nucleoside reverse transcriptase inhibitors (NRTIs) +1 protease inhibitor (PI) (n = 64) or 2 NRTIs + 1 non-nucleoside reverse transcriptase inhibitor (NNRTI) (n = 2)] and 14 patients (1 7.5%) started with a dual therapy because of ongoing antitubercular therapy or efficient previous bitherapy for the ART-experienced patients. The emergence of drug-resistant viruses (n = 13) during follow-up was more frequent in ART-experienced patients than in ART-naive patients, 41.7 versus 11.8%, resistant viruses emerged at comparable follow-up periods, a median of 17.8 and 18.3 months, respectively. In patients receiving zidovudine and lamivudine in their drug regimen, resistance to lamivudine was more frequent than to zidovudine. Two of the three patients, with viruses resistant to PIs, acquired mutations associated with cross-resistance. Strikingly, five (39%) of the 13 patients developed resistances to drugs that they had never received (n = 3) or that they received 18 or 36 months ago (n = 2). Didanosine/stavudine pressure had selected zidovudine-resistant viruses in four patients, and indinavir had selected a nelfinavir-resistant virus in one patient. Conclusion: In contrast to other reports from developing countries where patients had received ARVs in an uncontrolled manner, our study showed that implementation of HAART together with good clinical, biological and logistical monitoring can reduce the emergence of resistant strains in Africa. © 2003 Lippincott Williams & Wilkins.
Authors & Co-Authors
Vergne, Laurence
France, Montpellier
Université de Montpellier
Kane, Coumba Touré
Senegal, Dakar
Le Dantec University Teaching Hospital
Laurent, Christian
France, Montpellier
Université de Montpellier
Diakhaté, Ndella D.
Senegal, Dakar
Fann University Hospital
Ngom-Guèye, Ndèye Fatou
Senegal, Dakar
Fann University Hospital
Guèye, Pape Mandoumbé
Senegal, Dakar
Military Hospital
Sow, Papa Salif
Senegal, Dakar
Fann University Hospital
Faye, Mame Awa
Senegal, Dakar
Fann University Hospital
Liégeois, Florian
France, Montpellier
Université de Montpellier
Ndir, Adama
Senegal, Dakar
National Aids Program
Laniéce, Isabelle
France, Montpellier
Université de Montpellier
Peeters, Martine F.
France, Montpellier
Université de Montpellier
Ndoye, Ibrahima
Senegal, Dakar
National Aids Program
Mboup, Souleymane
Senegal, Dakar
Le Dantec University Teaching Hospital
Delaporte, Éric
France, Montpellier
Université de Montpellier
France, Montpellier
Recherches Translationnelles Sur le Vih et Les Maladies Infectieuses
Statistics
Citations: 60
Authors: 15
Affiliations: 6
Identifiers
Doi:
10.1097/00002030-200317003-00005
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study