Frequency of Transmitted Drug Resistance Mutations Among Treatment-Naïve HIV-1-Infected Individuals at a Tertiary Care Centre in South India

Kannangai, Rajesh; David, Sachin; Sundaresan, Vijayanand C.; Sachithanandham, Jaiprasath; Mani, Monika; Abraham, Ooriapadickal Cherian; Pulimood, Susanne; Rupali, Priscilla; Sridharan, Gopalan

doi:10.1007/s40291-015-0160-5

Cited by 7 publications

(3 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These baseline mutations were most predictive of resistance to efavirenz‐ or rilpivirine‐containing regimens. Other regions of the world with less established use of ART, such as Africa and Asia, report much lower rates of TDR (< 1–8.7%) . The drug class with the highest baseline resistance identified is NRTIs, with reported rates between 1% and 15.8% .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of HIV‐1 transmitted drug resistance in the incarcerated population

et al. 2017

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Prevalence of HIV‐1 transmitted drug resistance in the incarcerated population

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Of note, our study results are limited by the cross-sectional study design and small sample size. In addition, pre-treatment HIVDR reports for the study participants were not available and were presumed to be below 5% [ 27 , 28 ]. Furthermore, even though we performed PVL and HIVDR testing on same plasma sample of all patients, a delay of 2 weeks was experienced from the time of detection of IF to PVL testing, as many of our patients are referred to us from distant clinics.…”

Section: Discussionmentioning

confidence: 99%

Antiretroviral resistance following immunological monitoring in a resource-limited setting of western India: A cross-sectional study

et al. 2017

View full text Add to dashboard Cite

BackgroundThe free antiretroviral therapy (ART) program in India still relies on the clinico-immunological monitoring for diagnosis of treatment failure. As the nucleoside reverse transcriptase inhibitor (NRTI) backbone is shared in first- and second-line regimens, accumulation of drug resistant mutations (DRMs) can compromise the efficacy of NRTI. This study was undertaken to describe the pattern of HIV DRMs following immunological monitoring and investigate its impact on the cycling of NRTI between first- and second-line ART.Methods and findingsThis cross-sectional study was performed at a state-sponsored ART clinic of Pune city in western India between January and June 2016. Consecutive adults receiving first-line ART with immunological failure (IF) were recruited for plasma viral load (PVL) estimation. Randomly selected 80 participants with PVL >1000 copies/mL underwent HIV drug resistance genotyping. Of these, 75 plasma sample were successfully genotyped. The median CD4 count and duration of ART at the time of failure were 98 (IQR: 61.60–153.50) cells/μL and 4.62 (IQR: 3.17–6.15) years, respectively. The prevalence of NRTI, non-NRTI, and major protease inhibitor resistance mutations were 89.30%, 96%, and 1.33%, respectively. Following first-line failure, sequences from 56.67% of individuals indicated low- to high-level resistance to all available NRTI. The proportion of sequences with ≥2 thymidine analogue mutations (TAMs) and ≥3 TAMs were 62.12% and 39.39%, respectively. An average of 1.98 TAMs per sequence were observed following IF as compared to 0.37 TAMs per sequence following targeted PVL monitoring at 12 months of ART from a prior study; this difference was significant (p<0.001).ConclusionThe option of cycling of NRTI analogues between first- and second-line regimens would no longer be effective if individuals are followed-up by immunological monitoring due to accumulation of mutations. Introduction of routine PVL monitoring is a priority for the long-term sustainability of free ART program in India.

show abstract

“…In the subset of countries in Southeast Asia, 2,021 individuals had data on pretreatment DRMs (Supplemental Table 22 in Additional file 1) [112][113][114][115][116][117][118]. None of the reports included data on NRTI-associated DRMs; 5% of individuals had pretreatment NNRTIassociated DRMs (n=90/1,756).…”

Section: Regional Prevalence Estimates: Southeast Asiamentioning

confidence: 99%

Prevalence of Pretreatment and Acquired HIV-1 Mutations Associated with Resistance to Lamivudine or Rilpivirine: A Systematic Review

et al. 2018

View full text Add to dashboard Cite

Background: Pretreatment and acquired drug resistance mutations (DRMs) can limit antiretroviral therapy effectiveness. Methods: We review prevalence of DRMs with resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs), focusing on lamivudine and rilpivirine, from 127 articles with >100,000 individuals with HIV-1 infection. Results: Estimated global prevalence of pretreatment resistance to any NRTI was 4% and to any NNRTI was 6%.Most prevalent DRMs resistant to lamivudine or rilpivirine were at positions E138 (4%), V179 (1%) and M184 (1%). Estimated acquired DRM prevalence was 58% for any NRTIs and 67% for any NNRTIs, most frequently at positions M184 (58%) and Y181 (21%). Conclusions: This review suggests low risk of lamivudineor rilpivirine-resistant mutations in treatment-naive, HIV-1-infected individuals.

show abstract

Frequency of Transmitted Drug Resistance Mutations Among Treatment-Naïve HIV-1-Infected Individuals at a Tertiary Care Centre in South India

Abstract: In countries like India, regular monitoring of TDRMs will provide better information for clinical practice improvement and policy making.

Cited by 7 publications

References 15 publications

Prevalence of HIV‐1 transmitted drug resistance in the incarcerated population

Prevalence of HIV‐1 transmitted drug resistance in the incarcerated population

Antiretroviral resistance following immunological monitoring in a resource-limited setting of western India: A cross-sectional study

Prevalence of Pretreatment and Acquired HIV-1 Mutations Associated with Resistance to Lamivudine or Rilpivirine: A Systematic Review

Contact Info

Product

Resources

About