Cargando…

Do HIV-1 non-B subtypes differentially impact resistance mutations and clinical disease progression in treated populations? Evidence from a systematic review

There are 31 million adults living with HIV-1 non-B subtypes globally, and about 10 million are on antiretroviral therapy (ART). Global evidence to guide clinical practice on ART response in HIV-1 non-B subtypes remains limited. We systematically searched 11 databases for the period 1996 to 2013 for...

Descripción completa

Detalles Bibliográficos
Autores principales: Bhargava, Madhavi, Cajas, Jorge Martinez, Wainberg, Mark A, Klein, Marina B, Pai, Nitika Pant
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Co-Action Publishing 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4083185/
https://www.ncbi.nlm.nih.gov/pubmed/24998532
http://dx.doi.org/10.7448/IAS.17.1.18944
_version_ 1782324338405408768
author Bhargava, Madhavi
Cajas, Jorge Martinez
Wainberg, Mark A
Klein, Marina B
Pai, Nitika Pant
author_facet Bhargava, Madhavi
Cajas, Jorge Martinez
Wainberg, Mark A
Klein, Marina B
Pai, Nitika Pant
author_sort Bhargava, Madhavi
collection PubMed
description There are 31 million adults living with HIV-1 non-B subtypes globally, and about 10 million are on antiretroviral therapy (ART). Global evidence to guide clinical practice on ART response in HIV-1 non-B subtypes remains limited. We systematically searched 11 databases for the period 1996 to 2013 for evidence. Outcomes documented included time to development of AIDS and/or death, resistance mutations, opportunistic infections, and changes in CD4 cell counts and viral load. A lack of consistent reporting of all clinical end points precluded a meta-analysis. In sum, genetic diversity that precipitated differences in disease progression in ART-naïve populations was minimized in ART-experienced populations, although variability in resistance mutations persisted across non-B subtypes. To improve the quality of patient care in global settings, recording HIV genotypes at baseline and at virologic failure with targeted non-B subtype-based point-of-care resistance assays and timely phasing out of resistance-inducing ART regimens is recommended.
format Online
Article
Text
id pubmed-4083185
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher Co-Action Publishing
record_format MEDLINE/PubMed
spelling pubmed-40831852014-07-10 Do HIV-1 non-B subtypes differentially impact resistance mutations and clinical disease progression in treated populations? Evidence from a systematic review Bhargava, Madhavi Cajas, Jorge Martinez Wainberg, Mark A Klein, Marina B Pai, Nitika Pant J Int AIDS Soc Review Article There are 31 million adults living with HIV-1 non-B subtypes globally, and about 10 million are on antiretroviral therapy (ART). Global evidence to guide clinical practice on ART response in HIV-1 non-B subtypes remains limited. We systematically searched 11 databases for the period 1996 to 2013 for evidence. Outcomes documented included time to development of AIDS and/or death, resistance mutations, opportunistic infections, and changes in CD4 cell counts and viral load. A lack of consistent reporting of all clinical end points precluded a meta-analysis. In sum, genetic diversity that precipitated differences in disease progression in ART-naïve populations was minimized in ART-experienced populations, although variability in resistance mutations persisted across non-B subtypes. To improve the quality of patient care in global settings, recording HIV genotypes at baseline and at virologic failure with targeted non-B subtype-based point-of-care resistance assays and timely phasing out of resistance-inducing ART regimens is recommended. Co-Action Publishing 2014-07-04 /pmc/articles/PMC4083185/ /pubmed/24998532 http://dx.doi.org/10.7448/IAS.17.1.18944 Text en © 2014 Bhargava M et al; licensee International AIDS Society http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Bhargava, Madhavi
Cajas, Jorge Martinez
Wainberg, Mark A
Klein, Marina B
Pai, Nitika Pant
Do HIV-1 non-B subtypes differentially impact resistance mutations and clinical disease progression in treated populations? Evidence from a systematic review
title Do HIV-1 non-B subtypes differentially impact resistance mutations and clinical disease progression in treated populations? Evidence from a systematic review
title_full Do HIV-1 non-B subtypes differentially impact resistance mutations and clinical disease progression in treated populations? Evidence from a systematic review
title_fullStr Do HIV-1 non-B subtypes differentially impact resistance mutations and clinical disease progression in treated populations? Evidence from a systematic review
title_full_unstemmed Do HIV-1 non-B subtypes differentially impact resistance mutations and clinical disease progression in treated populations? Evidence from a systematic review
title_short Do HIV-1 non-B subtypes differentially impact resistance mutations and clinical disease progression in treated populations? Evidence from a systematic review
title_sort do hiv-1 non-b subtypes differentially impact resistance mutations and clinical disease progression in treated populations? evidence from a systematic review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4083185/
https://www.ncbi.nlm.nih.gov/pubmed/24998532
http://dx.doi.org/10.7448/IAS.17.1.18944
work_keys_str_mv AT bhargavamadhavi dohiv1nonbsubtypesdifferentiallyimpactresistancemutationsandclinicaldiseaseprogressionintreatedpopulationsevidencefromasystematicreview
AT cajasjorgemartinez dohiv1nonbsubtypesdifferentiallyimpactresistancemutationsandclinicaldiseaseprogressionintreatedpopulationsevidencefromasystematicreview
AT wainbergmarka dohiv1nonbsubtypesdifferentiallyimpactresistancemutationsandclinicaldiseaseprogressionintreatedpopulationsevidencefromasystematicreview
AT kleinmarinab dohiv1nonbsubtypesdifferentiallyimpactresistancemutationsandclinicaldiseaseprogressionintreatedpopulationsevidencefromasystematicreview
AT painitikapant dohiv1nonbsubtypesdifferentiallyimpactresistancemutationsandclinicaldiseaseprogressionintreatedpopulationsevidencefromasystematicreview