Journal ArticleDOI
Effect of transmitted drug resistance on virological and immunological response to initial combination antiretroviral therapy for HIV (EuroCoord-CHAIN joint project): a European multicohort study
Linda Wittkop,Huldrych F. Günthard,Frank de Wolf,David Dunn,Alessandro Cozzi-Lepri,Alessandro Cozzi-Lepri,Andrea De Luca,Andrea De Luca,Claudia Kücherer,Niels Obel,Viktor von Wyl,Bernard Masquelier,Christoph Stephan,Carlo Torti,Andrea Antinori,Federico García,Ali Judd,Kholoud Porter,Rodolphe Thiébaut,Hannah Castro,Ard van Sighem,Céline Colin,Jesper Kjaer,Jens D Lundgren,Roger Paredes,Anton Pozniak,Bonaventura Clotet,Andrew N. Phillips,Deenan Pillay,Geneviève Chêne +29 more
TLDR
Findings confirm present treatment guidelines for HIV, which state that the initial treatment choice should be based on resistance testing in treatment-naive patients, that the effect of TDR on outcome in the first year of cART is confirmed.Abstract:
Summary Background The effect of transmitted drug resistance (TDR) on first-line combination antiretroviral therapy (cART) for HIV-1 needs further study to inform choice of optimum drug regimens. We investigated the effect of TDR on outcome in the first year of cART within a large European collaboration. Methods HIV-infected patients of any age were included if they started cART (at least three antiretroviral drugs) for the first time after Jan 1, 1998, and were antiretroviral naive and had at least one sample for a genotypic test taken before the start of cART. We used the WHO drug resistance list and the Stanford algorithm to classify patients into three resistance categories: no TDR, at least one mutation and fully-active cART, or at least one mutation and resistant to at least one prescribed drug. Virological failure was defined as time to the first of two consecutive viral load measurements over 500 copies per mL after 6 months of therapy. Findings Of 10 056 patients from 25 cohorts, 9102 (90·5%) had HIV without TDR, 475 (4·7%) had at least one mutation but received fully-active cART, and 479 (4·8%) had at least one mutation and resistance to at least one drug. Cumulative Kaplan-Meier estimates for virological failure at 12 months were 4·2% (95% CI 3·8–4·7) for patients in the no TDR group, 4·7% (2·9–7·5) for those in the TDR and fully-active cART group, and 15·1% (11·9–19·0) for those in the TDR and resistant group (log-rank p Interpretation These findings confirm present treatment guidelines for HIV, which state that the initial treatment choice should be based on resistance testing in treatment-naive patients. Funding European Community's Seventh Framework Programme FP7/2007-2013 and Gilead.read more
Citations
More filters
Journal ArticleDOI
British HIV Association guidelines for the treatment of HIV-1-positive adults with antiretroviral therapy 2012
Ian Williams,Duncan Churchill,Jane Anderson,Marta Boffito,Mark Bower,Gus Cairns,Kate Cwynarski,Simon Edwards,Sarah Fidler,Martin Fisher,Andrew Freedman,Anna Maria Geretti,Yvonne Gilleece,Rob Horne,Margaret Johnson,Saye Khoo,Clifford Leen,Clifford Leen,Neal Marshall,Mark T. Nelson,Chloe Orkin,Nicholas I. Paton,Andrew N. Phillips,Frank A. Post,Frank A. Post,Anton Pozniak,Caroline A. Sabin,Roy Trevelion,Andrew Ustianowski,John Walsh,Laura Waters,Edmund Wilkins,Alan Winston,Alan Winston,M Youle +34 more
TL;DR: These guidelines are aimed at clinical professionals directly involved with and responsible for the care of adults with HIV infection and at community advocates responsible for promoting the best interests and care of HIV-positive adults.
Journal ArticleDOI
Global trends in antiretroviral resistance in treatment-naive individuals with HIV after rollout of antiretroviral treatment in resource-limited settings: a global collaborative study and meta-regression analysis
Ravindra K. Gupta,Michael R. Jordan,Binta Sultan,Andrew Hill,Daniel Davis,John Gregson,Anthony W. Sawyer,Raph L. Hamers,Nicaise Ndembi,Deenan Pillay,Silvia Bertagnolio +10 more
TL;DR: A significant increase in prevalence of drug resistance over time since antiretroviral rollout in regions of sub-Saharan Africa is suggested; this rise is driven by NNRTI resistance in studies from east and southern Africa.
Journal ArticleDOI
HIV-1 drug resistance in antiretroviral-naive individuals in sub-Saharan Africa after rollout of antiretroviral therapy: a multicentre observational study
Raph L. Hamers,Carole L. Wallis,Cissy Kityo,Margaret Siwale,Kishor Mandaliya,Francesca Conradie,Mariette E. Botes,Maureen Wellington,Akin Osibogun,Kim C. E. Sigaloff,Immaculate Nankya,Rob Schuurman,Ferdinand W. N. M. Wit,Wendy S. Stevens,Michèle van Vugt,Tobias F. Rinke de Wit +15 more
TL;DR: The higher prevalence of primary drug resistance in Uganda than in other African countries is probably related to the earlier start of ART roll-out in Uganda.
Journal ArticleDOI
Safety and antiretroviral activity of chronic subcutaneous administration of t-20 in human immunodeficiency virus 1-infected children
TL;DR: The use of combination antiretroviral therapy has been associated with a substantial decline in morbidity and mortality in human immunodeficiency virus (HIV)-infected individuals and pharmacologic agents effective at alternative stages in the replication cycle of the virus are identified.
Journal ArticleDOI
HIV-1 Antiretroviral Resistance: Scientific Principles and Clinical Applications
Michele W. Tang,Robert W. Shafer +1 more
TL;DR: A thorough examination of the patient’s ARV history and prior resistance tests should be performed because genotypic and/or phenotypic susceptibility testing is often not sufficient to identify drug-resistant variants that emerged during past therapies and may still pose a threat to a new regimen.
References
More filters
Journal ArticleDOI
Antiretroviral Treatment of Adult HIV Infection: 2012 Recommendations of the International Antiviral Society–USA Panel
Huldrych F. Günthard,Judith A. Aberg,Joseph J. Eron,Jennifer F Hoy,Amalio Telenti,Constance A. Benson,David M. Burger,Pedro Cahn,Joel E. Gallant,Marshall J. Glesby,Peter Reiss,Michael S. Saag,David L. Thomas,Donna M. Jacobsen,Paul A. Volberding +14 more
TL;DR: This report provides guidelines for when to initiate antiretroviral therapy, selection of appropriate initial regimens, patient monitoring, when to change therapy, and what regimens to use when changing.
Journal ArticleDOI
Antiretroviral Therapy for HIV Infection in 1997: Updated Recommendations of the International AIDS Society—USA Panel
Charles C. J. Carpenter,Margaret A. Fischl,Scott M. Hammer,Martin S. Hirsch,Donna M. Jacobsen,David Katzenstein,Julio S. G. Montaner,Douglas D. Richman,Michael S. Saag,Robert T. Schooley,Melanie A. Thompson,Stefano Vella,Patrick Yeni,Paul A. Volberding +13 more
TL;DR: Accumulating data from clinical and pathogenesis studies continue to support early institution of potent antiretroviral therapy in patients with HIV infection, and increased complexity in HIV management requires ongoing monitoring of new data for optimal treatment of HIV infection.
Journal ArticleDOI
Antiretroviral-Drug Resistance among Patients Recently Infected with HIV
Susan J. Little,Sarah Holte,Jean-Pierre Routy,Eric S. Daar,Marty Markowitz,Ann C. Collier,Richard A. Koup,John W. Mellors,Elizabeth Connick,Brian Conway,Michael Kilby,Lei Wang,Jeannette M. Whitcomb,Nicholas S. Hellmann,Douglas D. Richman +14 more
TL;DR: Testing for resistance to drugs before therapy begins is now indicated even for recently infected patients, as the proportion of new HIV infections that involve drug-resistant virus is increasing in North America.
Journal ArticleDOI
British HIV Association guidelines for the treatment of HIV-1-infected adults with antiretroviral therapy 2008
Brian Gazzard,Jane Anderson,Abdel Babiker,Marta Boffito,Gary Brook,Gary Brough,Duncan Churchill,Ben Cromarty,Satyajit Das,Martin Fisher,Andrew L. Freedman,Anna Maria Geretti,Margaret A. Johnson,Saye Khoo,Clifford Leen,Devaki Nair,Barry Peters,Andrew N. Phillips,Deenan Pillay,Anton Pozniak,John P. Walsh,Ed Wilkins,Ian S. Williams,Matthew Williams,M Youle +24 more
TL;DR: The 2008 BHIVA Guidelines have been updated to incorporate all the new relevant information since the last iteration and all the peer-reviewed publications and important, potentially treatment-changing abstracts from the last 2 years have been reviewed.
Antiretroviral Treatment of Adult HIV Infection
Scott M. Hammer,Joseph J. Eron,Peter Reiss,Robert T. Schooley,Melanie A. Thompson,Sharon Walmsley,Pedro Cahn,Margaret A. Fischl,José M. Gatell,Martin S. Hirsch,Donna M. Jacobsen,Julio S. G. Montaner,Douglas D. Richman,Patrick Yeni,Paul A. Volberding +14 more
TL;DR: This report provides guidelines in key areas of antiretroviral management: when toinitiatetherapy, choice of initialimens, patient monitoring, and how best to approach treatment options, including optimal use of recently approved drugs in treatment-experienced patients.
Related Papers (5)
Drug Resistance Mutations for Surveillance of Transmitted HIV-1 Drug-Resistance: 2009 Update
Diane E Bennett,Ricardo Jorge Camacho,Dan Otelea,Daniel R. Kuritzkes,Hervé Fleury,Mark Kiuchi,Walid Heneine,Rami Kantor,Michael R. Jordan,Jonathan M. Schapiro,Anne-Mieke Vandamme,Paul Sandstrom,Charles A. Boucher,Charles A. Boucher,David A. M. C. van de Vijver,Soo-Yon Rhee,Tommy F. Liu,Deenan Pillay,Robert W. Shafer +18 more
Low-frequency HIV-1 drug resistance mutations and risk of NNRTI-based antiretroviral treatment failure: a systematic review and pooled analysis
Jonathan Z. Li,Roger Paredes,Heather J. Ribaudo,Evguenia S. Svarovskaia,Karin J. Metzner,Michael J. Kozal,Katherine Huppler Hullsiek,Melanie Balduin,Martin R. Jakobsen,Anna Maria Geretti,Rodolphe Thiébaut,Lars Østergaard,Bernard Masquelier,Jeffrey A. Johnson,Michael D. Miller,Daniel R. Kuritzkes +15 more