The effect of transmitted HIV-1 drug resistance on pre-therapy viral load

By:

Harrison, L

Contributor(s):

Publication details: 2010ISSN:

02699370

Uniform titles:

AIDS

Online resources:

Summary: BACKGROUND: Reduced replication capacity of viruses expressing drug resistantmutations implies that patients with transmitted drug resistance(TDR) could have lower HIV RNA viral load than those infected with wild-typevirus.METHODS: We performed analysis using data from the UK HIV Drug ResistanceDatabase and the UK CHIC study. Eligible patients had a resistance testperformed between 1997 and 2007 while naive to antiretroviral therapy, were 16years or older, and had a viral load and CD4 cell count measurement within 6months of this test. Models were adjusted for CD4 cell count, viral subtype,ethnicity, risk group, sex, age, calendar year, clinical centre, and viral loadassay.RESULTS: Of a total of 7994 patients included, 709 (9%) had TDR: 604 (85%) hadresistance to one drug classonly [350 nucleos(t)ide reverse transcriptase inhibitors (NRTIs), 164non-nucleos(t)ide reverse transcriptase inhibitors (NNRTIs), 90 proteaseinhibitors (PIs)], 77 (11%) to two classes (42 NRTIs/NNRTIs, 31 NRTIs/PIs, 4NNRTIs/PIs), and 28 (4%) had resistance to all three classes. The overall mean(SD) viral load at the time of resistance testing was 4.60 (0.82) log(10)copies/ml, and did not differ by class of TDR. However, patients harbouringM184V/I (n = 61) had a significantly lower viral load [adjusted mean difference-0.33 log10 copies/ml (95% CI -0.54 to -0.11), 53% lower (95% CI 22 to 71%), P= 0.002] compared to wild-type virus.

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Item type	Home library	Collection	Class number	Status	Date due	Barcode
UNKNOWN	Ferriman information and Library Service (North Middlesex) Online	Staff publications for NMDX		Available

NMUH Staff Publications

BACKGROUND: Reduced replication capacity of viruses expressing&nbsp;drug&nbsp;resistantmutations implies that patients with transmitted&nbsp;drug&nbsp;resistance(TDR) could have lower HIV RNA viral load than those infected with wild-typevirus.METHODS: We performed analysis using&nbsp;data&nbsp;from the UK HIV&nbsp;Drug&nbsp;ResistanceDatabase and the UK CHIC study. Eligible patients had a resistance testperformed between 1997 and 2007 while naive to antiretroviral therapy, were 16years or older, and had a viral load and CD4 cell count measurement within 6months of this test. Models were adjusted for CD4 cell count, viral subtype,ethnicity, risk group, sex, age, calendar year, clinical centre, and viral loadassay.RESULTS: Of a total of 7994 patients included, 709 (9%) had TDR: 604 (85%) hadresistance to one&nbsp;drug&nbsp;classonly [350 nucleos(t)ide reverse transcriptase inhibitors (NRTIs), 164non-nucleos(t)ide reverse transcriptase inhibitors (NNRTIs), 90 proteaseinhibitors (PIs)], 77 (11%) to two classes (42 NRTIs/NNRTIs, 31 NRTIs/PIs, 4NNRTIs/PIs), and 28 (4%) had resistance to all three classes. The overall mean(SD) viral load at the time of resistance testing was 4.60 (0.82) log(10)copies/ml, and did not differ by class of TDR. However, patients harbouringM184V/I (n = 61) had a significantly lower viral load [adjusted mean difference-0.33 log10 copies/ml (95% CI -0.54 to -0.11), 53% lower (95% CI 22 to 71%), P= 0.002] compared to wild-type virus.

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