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Genotypic Resistance at Viral Rebound Among Patients Who Received Lopinavir/Ritonavir-Based or Efavirenz-Based First Antiretroviral Therapy in South Africa

  1. Author:
    Dlamini, J. N.
    Hu, Z. H.
    Ledwaba, J.
    Morris, L.
    Maldarelli, F. M.
    Dewar, R. L.
    Highbarger, H. C.
    Somaroo, H.
    Sangweni, P.
    Follmann, D. A.
    Pau, A. K.
    Phidisa, I. I. S. T.

  2. Author Address

    [Hu, ZH; Follmann, DA; Pau, AK] NIAID, NIH, Div Clin Res, Bethesda, MD 20895 USA. [Dlamini, JN] SAMHS, Off Clin Operat, Project Phidisa, Pretoria, South Africa. [Ledwaba, J; Morris, L] NICD, AIDS Virus Res Unit, Johannesburg, South Africa. [Maldarelli, FM] NCI, HIV Drug Resistance Program, NIH, Bethesda, MD 20892 USA. [Dewar, RL; Highbarger, HC] NCI, Virus Isolat & Serol Lab, SAIC Frederick Inc, Frederick, MD 21701 USA. [Somaroo, H] SAMHS, Mil Hosp 2, Project Phidisa, Cape Town, South Africa. [Sangweni, P] SAMHS, Lab Sect, Project Phidisa, Pretoria, South Africa.;Pau, AK (reprint author), NIAID, NIH, Div Clin Res, Bldg 10,Room 11C103,MSC 1880, Bethesda, MD 20895 USA;apau@niaid.nih.gov
    1. Year: 2011
    2. Date: Nov
  2. Journal: Jaids-Journal of Acquired Immune Deficiency Syndromes
    1. 58
    2. 3
    3. Pages: 304-308
  4. Type of Article: Article
  5. ISSN: 1525-4135
  1. Abstract:

    Nonnucleoside reverse transcriptase inhibitor-drug resistance mutations (DRM) are increasingly reported in Africans failing their first antiretroviral regimen. The Phidisa II trial randomized treatment-naive participants to lopinavir/ritonavir or efavirenz with stavudine + lamivudine or zidovudine + didanosine. We report the prevalence of DRM in subjects who achieved HIV RNA <400 copies per milliliter at 6 months, but subsequently had 2 consecutive HIV RNA >1000 copies per milliliter. Sixty-eight participants fulfilled the inclusion criteria. nonnucleoside reverse transcriptase inhibitor-DRM were found in 17 of 36 (47.2%) efavirenz recipients, and M184V/I mutation in 14 of 40 (35.0%) lamivudine recipients. No protease inhibitor mutation was identified in 38 lopinavir/ritonavir recipients. This is one of the first studies in Africa confirming the paucity of protease inhibitor-associated DRM despite virologic failure.

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External Sources

  1. View Full Text
  2. DOI: 10.1097/QAI.0b013e3182278c29
  3. View record in Web of Science®
  4. WOS: 000296383900022

Library Notes

  1. Fiscal Year: FY2011-2012

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