| dc.contributor |
Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy. a.soria@hsgerardo.org |
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| dc.creator |
Soria, A |
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| dc.creator |
Porten, K |
|
| dc.creator |
Fampou-Toundji, J |
|
| dc.creator |
Galli, L |
|
| dc.creator |
Mougnutou, R |
|
| dc.creator |
Buard, V |
|
| dc.creator |
Kfutwah, A |
|
| dc.creator |
Vessière, A |
|
| dc.creator |
Rousset, D |
|
| dc.creator |
Teck, R |
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| dc.creator |
Calmy, A |
|
| dc.creator |
Ciaffi, L |
|
| dc.creator |
Lazzarin, A |
|
| dc.creator |
Gianotti, N |
|
| dc.date |
2009-08 |
|
| dc.date.accessioned |
2017-01-31T07:15:03Z |
|
| dc.date.available |
2017-01-31T07:15:03Z |
|
| dc.identifier |
Resistance profiles after different periods of exposure to a first-line antiretroviral regimen in a Cameroonian cohort of HIV type-1-infected patients. 2009, 14 (3):339-47 Antivir. Ther. (Lond.) |
|
| dc.identifier |
1359-6535 |
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| dc.identifier |
19474468 |
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| dc.identifier |
http://hdl.handle.net/10144/81753 |
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| dc.identifier |
http://fieldresearch.msf.org/msf/handle/10144/81753 |
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| dc.identifier |
Antiviral Therapy |
|
| dc.identifier.uri |
http://dspace.mediu.edu.my:8181/xmlui/handle/10144/81753 |
|
| dc.description |
BACKGROUND: The lack of HIV type-1 (HIV-1) viral load (VL) monitoring in resource-limited settings might favour the accumulation of resistance mutations and thus hamper second-line treatment efficacy. We investigated the factors associated with resistance after the initiation of antiretroviral therapy (ART) in the absence of virological monitoring. METHODS: Cross-sectional VL sampling of HIV-1-infected patients receiving first-line ART (nevirapine or efavirenz plus stavudine or zidovudine plus lamivudine) was carried out; those with a detectable VL were genotyped. RESULTS: Of the 573 patients undergoing VL sampling, 84 were genotyped. The mean number of nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) mutations increased with the duration of ART exposure (P=0.02). Multivariable analysis showed that patients with a CD4+ T-cell count < or =50 cells/mm(3) at ART initiation (baseline) had a higher mean number of both NRTI and non-NRTI (NNRTI) mutations than those with a baseline CD4+ T-cell count >50 cells/mm(3) (2.10 versus 0.56; P<0.0001; and 1.65 versus 0.76; P=0.005, respectively). A baseline CD4+ T-cell count < or =50 cells/mm(3) predicted > or =1 NRTI mutation (adjusted odds ratio [AOR] 7.49, 95% confidence interval [CI] 2.20-32.14), > or =1 NNRTI mutation (AOR 4.25, 95% CI 1.36-15.48), > or =1 thymidine analogue mutation (AOR 8.45, 95% CI 2.16-40.16) and resistance to didanosine (AOR 6.36, 95% CI 1.49-32.29) and etravirine (AOR 4.72, 95% CI 1.53-15.70). CONCLUSIONS: Without VL monitoring, the risk of drug resistance increases with the duration of ART and is associated with lower CD4+ T-cell counts at ART initiation. These data might help define strategies to preserve second-line treatment options in resource-limited settings. |
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| dc.language |
en |
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| dc.relation |
http://www.intmedpress.com |
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| dc.rights |
Archived on this site with kind permission of International Medical Press. http://www.intmedpress.com |
|
| dc.title |
Resistance profiles after different periods of exposure to a first-line antiretroviral regimen in a Cameroonian cohort of HIV type-1-infected patients. |
|