HIV-1 drug resistance in antiretroviral-naive individuals with HIV-1-associated tuberculous meningitis initiating antiretroviral therapy in Vietnam.
| dc.contributor.author | Thao, Vu P | |
| dc.contributor.author | Le, Thuy | |
| dc.contributor.author | Török, Estee M | |
| dc.contributor.author | Yen, Nguyen TB | |
| dc.contributor.author | Chau, Tran TH | |
| dc.contributor.author | Jurriaans, Suzanne | |
| dc.contributor.author | van Doorn, H Rogier | |
| dc.contributor.author | de Jong, Menno D | |
| dc.contributor.author | Farrar, Jeremy J | |
| dc.contributor.author | Dunstan, Sarah J | |
| dc.coverage.spatial | England | |
| dc.date.accessioned | 2018-03-16T19:36:41Z | |
| dc.date.available | 2018-03-16T19:36:41Z | |
| dc.date.issued | 2012 | |
| dc.description.abstract | BACKGROUND: Access to antiretroviral therapy (ART) for HIV-infected individuals in Vietnam is rapidly expanding, but there are limited data on HIV drug resistance (HIVDR) to guide ART strategies. METHODS: We retrospectively conducted HIVDR testing in 220 ART-naive individuals recruited to a randomized controlled trial of immediate versus deferred ART in individuals with HIV-associated tuberculous meningitis in Ho Chi Minh City (HCMC) from 2005-2008. HIVDR mutations were identified by population sequencing of the HIV pol gene and were defined based on 2009 WHO surveillance drug resistance mutations (SDRMs). RESULTS: We successfully sequenced 219/220 plasma samples of subjects prior to ART; 218 were subtype CRF01_AE and 1 was subtype B. SDRMs were identified in 14/219 (6.4%) subjects; 8/14 were resistant to nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs; T69D, L74V, V75M, M184V/I and K219R), 5/14 to non-nucleoside reverse transcriptase inhibitors (NNRTIs; K103N, V106M, Y181C, Y188C and G190A), 1/14 to both NRTIs and NNRTIs (D67N and Y181C) and none to protease inhibitors. After 6 months of ART, eight subjects developed protocol-defined virological failure. HIVDR mutations were identified in 5/8 subjects. All five had mutations with high-level resistance to NNRTIs and three had mutations with high-level resistance to NRTIs. Due to a high early mortality rate (58%), the effect of pre-existing HIVDR mutations on treatment outcome could not be accurately assessed. CONCLUSIONS: The prevalence of WHO SDRMs in ART-naive individuals with HIV-associated tuberculous meningitis in HCMC from 2005-2008 is 6.4%. The SDRMs identified conferred resistance to NRTIs and/or NNRTIs, reflecting the standard first-line ART regimens in Vietnam. | |
| dc.identifier | ||
| dc.identifier.eissn | 2040-2058 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | International Medical Press | |
| dc.relation.ispartof | Antivir Ther | |
| dc.relation.isversionof | 10.3851/IMP2092 | |
| dc.subject | Anti-HIV Agents | |
| dc.subject | Coinfection | |
| dc.subject | Drug Resistance, Viral | |
| dc.subject | Genotype | |
| dc.subject | HIV Infections | |
| dc.subject | HIV-1 | |
| dc.subject | Humans | |
| dc.subject | Mutation | |
| dc.subject | Polymorphism, Genetic | |
| dc.subject | Prevalence | |
| dc.subject | Treatment Failure | |
| dc.subject | Tuberculosis, Meningeal | |
| dc.subject | Vietnam | |
| dc.title | HIV-1 drug resistance in antiretroviral-naive individuals with HIV-1-associated tuberculous meningitis initiating antiretroviral therapy in Vietnam. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Le, Thuy|0000-0002-3393-6580 | |
| pubs.author-url | ||
| pubs.begin-page | 905 | |
| pubs.end-page | 913 | |
| pubs.issue | 5 | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | Medicine | |
| pubs.organisational-group | Medicine, Infectious Diseases | |
| pubs.organisational-group | School of Medicine | |
| pubs.publication-status | Published | |
| pubs.volume | 17 |
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