Viral load and CD4 cell response to protease inhibitor-containing regimens in subtype B versus non-B treatment-naive HIV-1 patients

Wit, Stéphane De; Boulmé, Ronan; Poll, Bénédicte; Schmit, Jean-Claude; Clumeck, Nathan

doi:10.1097/00002030-200411190-00016

Cited by 35 publications

(34 citation statements)

References 6 publications

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“…Although some short-term studies suggest little difference in therapy response in patients carrying non-B subtypes from that of patients infected with subtype B (12), other studies showed a significant difference in responses to treatment for different subtypes (8,13). However, current studies have included a limited number of subjects.…”

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confidence: 90%

Discordances between Interpretation Algorithms for Genotypic Resistance to Protease and Reverse Transcriptase Inhibitors of Human Immunodeficiency Virus Are Subtype Dependent

Snoeck

Kantor

Shafer

et al. 2006

Antimicrob Agents Chemother

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The major limitation of drug resistance genotyping for human immunodeficiency virus remains the interpretation of the results. We evaluated the concordance in predicting therapy response between four different interpretation algorithms (Rega 6.3, HIVDB-08/04, ANRS [07/04], and VGI 8.0). Sequences were gathered through a worldwide effort to establish a database of non-B subtype sequences, and demographic and clinical information about the patients was gathered. The most concordant results were found for nonnucleoside reverse transcriptase (RT) inhibitors (93%), followed by protease inhibitors (84%) and nucleoside RT inhibitor (NRTIs) (76%). For therapy-naive patients, for nelfinavir, especially for subtypes C and G, the discordances were driven mainly by the protease (PRO) mutational pattern 82I/V ؉ 63P ؉ 36I/V for subtype C and 82I ؉ 63P ؉ 36I ؉ 20I for subtype G. Subtype F displayed more discordances for ritonavir in untreated patients due to the combined presence of PRO 20R and 10I/V. In therapy-experienced patients, subtype G displayed a lot of discordances for saquinavir and indinavir due to mutational patterns involving PRO 90 M and 82I. Subtype F had more discordance for nelfinavir attributable to the presence of PRO 88S and 82A ؉ 54V. For the NRTIs lamivudine and emtricitabine, CRF01_AE had more discordances than subtype B due to the presence of RT mutational patterns 65R ؉ 115 M and 118I ؉ 215Y, respectively. Overall, the different algorithms agreed well on the level of resistance scored, but some of the discordances could be attributed to specific (subtypedependent) combinations of mutations. It is not yet known whether therapy response is subtype dependent, but the advice given to clinicians based on a genotypic interpretation algorithm differs according to the subtype.Genotyping for the assessment of anti-human immunodeficiency virus (HIV) drug resistance is often used in the management of individual patient therapy. Currently, it is recommended in European as well as American guidelines (17,38). In several retrospective and prospective studies, genotyping proved beneficial in optimizing treatment for individual patients (5,10,16,23,25,31,37).Although genotyping is commonly used, there are still many uncertainties with respect to the value of genotype in the assignment of a new regimen. The current genotypic assays are not always able to report all drug resistance mutations among non-B subtypes (11,18,19,24). Regardless of subtype, genotyping is not sensitive to mutations that are present as a minor variant in the population (22,40). Genotyping results also differ depending on the laboratory where they are performed. Quality control studies indicate that mutations, even present as a pure variant, are often underestimated (32).However, separate from the quality and sensitivity issues, the interpretation of genotypic results is still not standardized.

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confidence: 90%

Discordances between Interpretation Algorithms for Genotypic Resistance to Protease and Reverse Transcriptase Inhibitors of Human Immunodeficiency Virus Are Subtype Dependent

Snoeck

Kantor

Shafer

et al. 2006

Antimicrob Agents Chemother

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“…57 Structural differences between subtypes may impact on diagnostic assays, susceptibility to antiretroviral drugs and to the development of drug resistance. 58,59 Although virological and immunological responses to antiretroviral therapy appear similar across subtypes, 60,61 there is increasing data to suggest that subtype variation in naturally occurring polymorphisms may have a role in the development of drug resistance. 62 HIV-2, found principally in West Africa, differs in structure from HIV-1 and is not susceptible to non-nucleoside reverse transcriptase inhibitors or to Enfurvitide, and also shows reduced susceptibility to various protease inhibitors.…”

Section: Viral Diversity and Subtype Variationmentioning

confidence: 99%

Coming and going: Some aspects of care for migrants with HIV in the UK

Anderson¹

2008

Journal of Infection

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“…In contrast, studies from South Africa [15] and Senegal [16] have reported resistance rates as low as 10%-11.8%. At least 4 studies have assessed treatment outcomes in African emigrants living in Europe [17][18][19][20]. In 1 study, African patients had a lower rate of CD4 + cell recovery [17]; in a second study, African patients were found to have an earlier viral rebound, compared with that in European patients [18].…”

Section: A J O R a R T I C L Ementioning

confidence: 99%

“…At least 4 studies have assessed treatment outcomes in African emigrants living in Europe [17][18][19][20]. In 1 study, African patients had a lower rate of CD4 + cell recovery [17]; in a second study, African patients were found to have an earlier viral rebound, compared with that in European patients [18]. In the other 2 studies, no difference was detected in the therapeutic response of African versus non-African patients [19,20].…”

Section: A J O R a R T I C L Ementioning

confidence: 99%

Therapeutic Response of HIV‐1 Subtype C in African Patients Coinfected with eitherMycobacterium tuberculosisor Human Herpesvirus–8

Cassol¹,

Page²,

Mosam³

et al. 2005

J INFECT DIS

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Viral load and CD4 cell response to protease inhibitor-containing regimens in subtype B versus non-B treatment-naive HIV-1 patients

Cited by 35 publications

References 6 publications

Discordances between Interpretation Algorithms for Genotypic Resistance to Protease and Reverse Transcriptase Inhibitors of Human Immunodeficiency Virus Are Subtype Dependent

Discordances between Interpretation Algorithms for Genotypic Resistance to Protease and Reverse Transcriptase Inhibitors of Human Immunodeficiency Virus Are Subtype Dependent

Coming and going: Some aspects of care for migrants with HIV in the UK

Therapeutic Response of HIV‐1 Subtype C in African Patients Coinfected with eitherMycobacterium tuberculosisor Human Herpesvirus–8

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