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Pretreatment resistance mutations and treatment outcomes in adults living with HIV-1: a cohort study in urban Malawi

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  • معلومة اضافية
    • Publication Information:
      BMC, 2020.
    • Publication Date:
      2020
    • Collection:
      LCC:Immunologic diseases. Allergy
    • Abstract:
      Abstract Background Pre-treatment drug resistance (PDR) among antiretroviral drug-naïve people living with HIV (PLHIV) represents an important indicator for the risk of treatment failure and the spread of drug resistant HIV variants. We assessed the prevalence of PDR and treatment outcomes among adults living with HIV-1 in Lilongwe, Malawi. Methods We selected 200 participants at random from the Lighthouse Tenofovir Cohort Study (LighTen). Serum samples were drawn prior to treatment initiation in 2014 and 2015, frozen, and later analyzed for the presence of HIV-1 drug resistance mutations. Amplicons were sequenced and interpreted by Stanford HIVdb interpretation algorithm 8.4. We assessed treatment outcomes by evaluating clinical outcome and viral suppression at the end of the follow-up period in October 2019. Results PDR testing was successful in 197 of 200 samples. The overall NNRTI- PDR prevalence was 13.7% (27/197). The prevalence of intermediate or high level NNRTI- PDR was 11.2% (22/197). The most common mutation was K103N (5.6%, 11/197), followed by Y181C (3.6%, 7/197). In one case, we detected an NRTI resistance mutation (M184V), in combination with multiple NNRTI resistance mutations. All HIV-1 isolates analyzed were of subtype C. Of the 27 patients with NNRTI- PDR, 9 were still alive, on ART, and virally suppressed at the end of follow-up. Conclusion The prevalence of NNRTI- PDR was above the critical level of 10% suggested by the Global Action Plan on HIV Drug Resistance. The distribution of drug resistance mutations was similar to that seen in previous studies from the region, and further supports the introduction of integrase inhibitors in first-line treatment in Malawi. Furthermore, our findings underline the need for continued PDR surveillance and pharmacovigilance in Sub-Saharan Africa.
    • File Description:
      electronic resource
    • ISSN:
      1742-6405
    • Relation:
      http://link.springer.com/article/10.1186/s12981-020-00282-3; https://doaj.org/toc/1742-6405
    • Accession Number:
      10.1186/s12981-020-00282-3
    • Rights:
      Journal Licence: CC BY
    • Accession Number:
      edsdoj.5733aa9f2a394533a89df99af43a8140
  • Citations
    • ABNT:
      F. NEUHANN et al. Pretreatment resistance mutations and treatment outcomes in adults living with HIV-1: a cohort study in urban Malawi. AIDS Research and Therapy, [s. l.], v. 17, n. 1, p. 1–7, 2020. DOI 10.1186/s12981-020-00282-3. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edsdoj&AN=edsdoj.5733aa9f2a394533a89df99af43a8140&custid=s8280428. Acesso em: 11 jul. 2020.
    • AMA:
      F. Neuhann, A. de Forest, E. Heger, et al. Pretreatment resistance mutations and treatment outcomes in adults living with HIV-1: a cohort study in urban Malawi. AIDS Research and Therapy. 2020;17(1):1-7. doi:10.1186/s12981-020-00282-3.
    • AMA11:
      F. Neuhann, A. de Forest, E. Heger, et al. Pretreatment resistance mutations and treatment outcomes in adults living with HIV-1: a cohort study in urban Malawi. AIDS Research and Therapy. 2020;17(1):1-7. doi:10.1186/s12981-020-00282-3
    • APA:
      F. Neuhann, A. de Forest, E. Heger, A. Nhlema, C. Scheller, R. Kaiser, H. M. Steffen, H. Tweya, G. Fätkenheuer, & S. Phiri. (2020). Pretreatment resistance mutations and treatment outcomes in adults living with HIV-1: a cohort study in urban Malawi. AIDS Research and Therapy, 17(1), 1–7. https://doi.org/10.1186/s12981-020-00282-3
    • Chicago/Turabian: Author-Date:
      F. Neuhann, A. de Forest, E. Heger, A. Nhlema, C. Scheller, R. Kaiser, H. M. Steffen, H. Tweya, G. Fätkenheuer, and S. Phiri. 2020. “Pretreatment Resistance Mutations and Treatment Outcomes in Adults Living with HIV-1: A Cohort Study in Urban Malawi.” AIDS Research and Therapy 17 (1): 1–7. doi:10.1186/s12981-020-00282-3.
    • Harvard:
      F. Neuhann et al. (2020) ‘Pretreatment resistance mutations and treatment outcomes in adults living with HIV-1: a cohort study in urban Malawi’, AIDS Research and Therapy, 17(1), pp. 1–7. doi: 10.1186/s12981-020-00282-3.
    • Harvard: Australian:
      F. Neuhann, A. de Forest, E. Heger, A. Nhlema, C. Scheller, R. Kaiser, H. M. Steffen, H. Tweya, G. Fätkenheuer & S. Phiri 2020, ‘Pretreatment resistance mutations and treatment outcomes in adults living with HIV-1: a cohort study in urban Malawi’, AIDS Research and Therapy, vol. 17, no. 1, pp. 1–7, viewed 11 July 2020, .
    • MLA:
      F. Neuhann, et al. “Pretreatment Resistance Mutations and Treatment Outcomes in Adults Living with HIV-1: A Cohort Study in Urban Malawi.” AIDS Research and Therapy, vol. 17, no. 1, May 2020, pp. 1–7. EBSCOhost, doi:10.1186/s12981-020-00282-3.
    • Chicago/Turabian: Humanities:
      F. Neuhann, A. de Forest, E. Heger, A. Nhlema, C. Scheller, R. Kaiser, H. M. Steffen, H. Tweya, G. Fätkenheuer, and S. Phiri. “Pretreatment Resistance Mutations and Treatment Outcomes in Adults Living with HIV-1: A Cohort Study in Urban Malawi.” AIDS Research and Therapy 17, no. 1 (May 1, 2020): 1–7. doi:10.1186/s12981-020-00282-3.
    • Vancouver/ICMJE:
      F. Neuhann, A. de Forest, E. Heger, A. Nhlema, C. Scheller, R. Kaiser, et al. Pretreatment resistance mutations and treatment outcomes in adults living with HIV-1: a cohort study in urban Malawi. AIDS Research and Therapy [Internet]. 2020 May 1 [cited 2020 Jul 11];17(1):1–7. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edsdoj&AN=edsdoj.5733aa9f2a394533a89df99af43a8140&custid=s8280428