Virologic suppression in response to antiretroviral therapy despite extensive resistance within HIV-1 reverse transcriptase after the first virologic failure.

BMC Infect Dis

Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Pernambuco, Av. Prof. Moraes Rego 1235, Recife, 50670-901, Brazil.

Published: October 2018

Background: Incomplete virologic suppression results in mutations associated with resistance and is a major obstacle to disease control. We analyzed the genotypic profiles of HIV-1 patients at the time of the first virologic failure and the response to a salvage regimen after 48 weeks.

Methods: This work was a cross-sectional, retrospective, analytical study based on data collected from medical records and genotyping tests between 2006 and 2016. The sample consisted of data on individuals living with HIV (PLWH) from three major reference centers.

Results: A total of 184 patients were included in the data analysis. Viral subtype B was the most common (81.3%) as well as M184 V/I (85.3%) and K103 codon mutations (65.8%). Forty-eight weeks after switching to a salvage regimen, 67.3% of patients achieved an undetectable viral load.

Discussion: The number of mutations associated with nucleos(t)ide reverse transcriptase inhibitors (NRTI(t)s) did not affect virologic suppression (9.3% for zero NRTI(t)-associated mutations vs 48.6% for 1-2 NRTI(t)-associated mutations vs 42.1% for ≥3 NRTI(t)-associated mutations, p = 0.179). An ARV time (the beginning of the first ARV regimen up to genotyping) of > 36 months was a protective factor for detectable viral load (PR = 0.60, 95% CI = 0.39-0.92, p = 0.020) and a risk factor for developing ≥3 NRTI(t)-associated mutations (PR = 2.43, 95% CI 1.38-4.28, p = 0.002).

Conclusions: We found that extensive resistance to NRTI(t)s at the time of the first virologic failure did not impact virologic suppression at 48 weeks after switching to a second-line therapy based on NRTI(t)s plus protease inhibitors.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186096PMC
http://dx.doi.org/10.1186/s12879-018-3400-6DOI Listing

Publication Analysis

Top Keywords

virologic suppression
16
nrtit-associated mutations
16
virologic failure
12
extensive resistance
8
reverse transcriptase
8
mutations associated
8
time virologic
8
salvage regimen
8
≥3 nrtit-associated
8
virologic
7

Similar Publications

Background: Recent biomedical research has shown the unusual, multisystem effects of coronavirus disease 2019 in humans. One specific sequela of a primary severe acute respiratory syndrome coronavirus 2 infection is the reactivation of latent viruses in various tissues, such as Epstein-Barr virus. Epstein-Barr virus has been identified in many inflammatory gastrointestinal lesions, such as microscopic gastritides and colitides.

View Article and Find Full Text PDF

Background: Real-world data on treatment patterns and clinical outcomes for newer drugs, including integrase strand transfer inhibitors, among older people with human immunodeficiency virus (PWH) are limited.

Methods: This cohort study included PWH enrolled in the Veterans Aging Cohort Study (VACS) who were prescribed a standard 3-drug antiretroviral therapy (ART) regimen containing dolutegravir (DTG), bictegravir (BIC), cobicistat boosted elvitegravir (EVG), raltegravir (RAL), or darunavir/ritonavir (DRV) plus 2 nucleoside reverse transcriptase inhibitors between January 1, 2014, and March 31, 2020, and who were ≥50 years at regimen initiation. The association between regimen and virologic effectiveness or discontinuation was assessed using logistic regression models with inverse probability of treatment weights.

View Article and Find Full Text PDF

Background: People living with HIV (PLHIV) demonstrate accelerated aging and immunosenescence in spite of immune-restoration following long-term antiretroviral treatment (ART). Low level inflammation leading to inflammaging plays an important role in mediating premature immunosenescence. Ongoing viral replication, antiretrovirals and subclinical infections with the common viruses like Cytomegalovirus (CMV) are known to induce inflammaging.

View Article and Find Full Text PDF

Shifts in seasonal influenza patterns in Australia during and after COVID-19: A comprehensive analysis.

J Infect Public Health

December 2024

Ecosystem Change and Population Health Research Group, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia. Electronic address:

Background: During the COVID-19 pandemic, seasonal influenza virus circulation was heavily suppressed worldwide. In Australia, since the virus re-emerged in 2022, shifts in seasonal influenza patterns have been observed. Both the 2022 and 2023 seasons started earlier than pre-pandemic norms and were categorised as moderate to severe, highlighting the renewed importance of prevention strategies for seasonal influenza.

View Article and Find Full Text PDF

African swine fever virus (ASFV) is a DNA virus that has significantly impacted the global swine industry. Currently, there are no effective therapies or vaccines against ASFV. Stress granules (SGs), known for their antiviral properties, are not induced during ASFV infection, even though reactive oxygen species (ROS) are generated.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!