HIV Drug Resistance in Adults Failing Early Antiretroviral Treatment: Results From the HIV Prevention Trials Network 052 Trial

被引:11
作者
Fogel, Jessica M. [1 ]
Hudelson, Sarah E. [1 ]
Ou, San-San [2 ]
Hart, Stephen [3 ]
Wallis, Carole [4 ,5 ]
Morgado, Mariza G. [6 ]
Saravanan, Shanmugam [7 ]
Tripathy, Srikanth [8 ]
Hovind, Laura [3 ]
Piwowar-Manning, Estelle [1 ]
Sabin, Devin [1 ]
McCauley, Marybeth [9 ]
Gamble, Theresa [10 ]
Zhang, Xinyi C. [2 ]
Eron, Joseph J. [11 ]
Gallant, Joel E. [12 ]
Kumwenda, Johnstone [13 ]
Makhema, Joseph [14 ]
Kumarasamy, Nagalingeswaran [15 ]
Chariyalertsak, Suwat [16 ]
Hakim, James [17 ]
Badal-Faesen, Sharlaa [18 ]
Akelo, Victor [19 ]
Hosseinipour, Mina C. [20 ,21 ]
Santos, Breno R. [22 ]
Godbole, Sheela V. [23 ]
Pilotto, Jose H. [24 ,25 ]
Grinsztejn, Beatriz [26 ]
Panchia, Ravindre [27 ]
Mayer, Kenneth H. [28 ,29 ]
Chen, Ying Q. [30 ,31 ]
Cohen, Myron S. [11 ]
Eshleman, Susan H. [1 ]
机构
[1] Johns Hopkins Univ, Sch Med, Dept Pathol, Baltimore, MD 21205 USA
[2] Fred Hutchinson Canc Res Ctr, Vaccine & Infect Dis Div, 1124 Columbia St, Seattle, WA 98104 USA
[3] Frontier Sci & Technol Res Fdn Inc, Amherst, NY USA
[4] Lancet Labs, Specialty Mol Div, Johannesburg, South Africa
[5] BARC SA, Johannesburg, South Africa
[6] Inst Oswaldo Cruz, Lab AIDS & Mol Immunol, BR-20001 Rio De Janeiro, Brazil
[7] YR Gaitonde Ctr AIDS Res & Educ, Chennai, Tamil Nadu, India
[8] Natl JALMA Inst Leprosy & Other Mycobacterial Dis, Agra, Uttar Pradesh, India
[9] FHI 360, Sci Facilitat Dept, Washington, DC USA
[10] FHI 360, Sci Facilitat Dept, Durham, NC USA
[11] Univ N Carolina, Dept Med, Chapel Hill, NC USA
[12] Southwest CARE Ctr, Santa Fe, NM USA
[13] Johns Hopkins Project, Coll Med, Blantyre, Malawi
[14] Botswana Harvard AIDS Inst, Gaborone, Botswana
[15] VHS, YRGCARE Med Ctr, Chennai, Tamil Nadu, India
[16] Chiang Mai Univ, Res Inst Hlth Sci, Chiang Mai 50000, Thailand
[17] Univ Zimbabwe, Dept Med, Harare, Zimbabwe
[18] Univ Witwatersrand, Wits Reprod Hlth & HIV Inst, Johannesburg, South Africa
[19] Ctr Dis Control, Kenya Med Res Inst, Kisumu, Kenya
[20] Univ N Carolina, Div Infect Dis, Chapel Hill, NC USA
[21] UNC Project Malawi, Inst Global Hlth & Infect Dis, Lilongwe, Malawi
[22] Hosp Nossa Senhora da Conceicao, Serv Infectol, Porto Alegre, RS, Brazil
[23] Natl AIDS Res Inst ICMR, Dept Epidemiol & Biostat, Pune, Maharashtra, India
[24] Hosp Geral de Nova Iguacu, Rio De Janeiro, Brazil
[25] Fiocruz MS, Lab AIDS & Imunol Mol IOC, BR-21045900 Rio De Janeiro, Brazil
[26] Fiocruz MS, Inst Nacl Infectol Evandro Chagas INI, BR-21045900 Rio De Janeiro, Brazil
[27] Univ Witwatersrand, Soweto HPTN CRS, Perinatal HIV Res Unit, Soweto, South Africa
[28] Fenway Inst, Fenway Hlth & Infect Dis Div, Boston, MA USA
[29] Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Dept Med, Boston, MA 02215 USA
[30] Fred Hutchinson Canc Res Ctr, Vaccine & Infect Dis Div, 1124 Columbia St, Seattle, WA 98104 USA
[31] Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, 1124 Columbia St, Seattle, WA 98104 USA
基金
美国国家卫生研究院;
关键词
HIV; HPTN; 052; early ART; ART failure; resistance; CELL COUNTS; THERAPY; INFECTION; INITIATION; FAILURE; MUTATIONS;
D O I
10.1097/QAI.0000000000000951
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Early initiation of antiretroviral treatment (ART) reduces HIV transmission and has health benefits. HIV drug resistance can limit treatment options and compromise use of ART for HIV prevention. We evaluated drug resistance in 85 participants in the HIV Prevention Trials Network 052 trial who started ART at CD4 counts of 350-550 cells per cubic millimeter and failed ART by May 2011; 8.2% had baseline resistance and 35.3% had resistance at ART failure. High baseline viral load and less education were associated with emergence of resistance at ART failure. Resistance at ART failure was observed in 7 of 8 (87.5%) participants who started ART at lower CD4 cell counts.
引用
收藏
页码:304 / 309
页数:6
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