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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Co-Action Publishing
2014
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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 |
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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 |
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