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High level of HIV-1 drug resistance among patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau

BACKGROUND: With the widespread use of antiretroviral treatment (ART) in Africa, the risk of drug resistance has increased. The aim of this study was to evaluate levels of HIV-1 resistance among patients with HIV-1 and HIV-1/2 dual infections, treated with ART, at a large HIV clinic in Guinea-Bissau...

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Autores principales: Jespersen, Sanne, Tolstrup, Martin, Hønge, Bo Langhoff, Medina, Candida, Té, David da Silva, Ellermann-Eriksen, Svend, Østergaard, Lars, Wejse, Christian, Laursen, Alex Lund
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357169/
https://www.ncbi.nlm.nih.gov/pubmed/25889017
http://dx.doi.org/10.1186/s12985-015-0273-9
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author Jespersen, Sanne
Tolstrup, Martin
Hønge, Bo Langhoff
Medina, Candida
Té, David da Silva
Ellermann-Eriksen, Svend
Østergaard, Lars
Wejse, Christian
Laursen, Alex Lund
author_facet Jespersen, Sanne
Tolstrup, Martin
Hønge, Bo Langhoff
Medina, Candida
Té, David da Silva
Ellermann-Eriksen, Svend
Østergaard, Lars
Wejse, Christian
Laursen, Alex Lund
author_sort Jespersen, Sanne
collection PubMed
description BACKGROUND: With the widespread use of antiretroviral treatment (ART) in Africa, the risk of drug resistance has increased. The aim of this study was to evaluate levels of HIV-1 resistance among patients with HIV-1 and HIV-1/2 dual infections, treated with ART, at a large HIV clinic in Guinea-Bissau. FINDINGS: Patients were selected from the Bissau HIV cohort. All patients had HIV-1 or HIV-1/2 dual infection, a CD4 cell count performed before and 3–12 months after starting ART, and a corresponding available plasma sample. We measured viral load in patients with HIV-1 (n = 63) and HIV-1/2 dual (n = 16) infections a median of 184 days after starting ART (IQR: 126–235 days). In patients with virological failure (defined as viral load >1000 copies/ml) and with sufficient plasma available, we performed an HIV-1 genotypic resistance test. Thirty-six patients (46%) had virological failure. The CD4 cell count did not predict treatment failure. Of the 36 patients with virological failure, we performed a resistance test in 15 patients (42%), and nine patients (9/15; 60%) had resistance mutations. The most common mutation was K103N, which confers high-level resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI). No major mutations against protease inhibitors (PI) were found. CONCLUSIONS: Our results showed that patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau had a high rate of virological failure and rapid development of NNRTI resistance. It remains to be determined whether a more robust, PI-based treatment regimen might benefit this population more than NNRTIs.
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spelling pubmed-43571692015-03-13 High level of HIV-1 drug resistance among patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau Jespersen, Sanne Tolstrup, Martin Hønge, Bo Langhoff Medina, Candida Té, David da Silva Ellermann-Eriksen, Svend Østergaard, Lars Wejse, Christian Laursen, Alex Lund Virol J Short Report BACKGROUND: With the widespread use of antiretroviral treatment (ART) in Africa, the risk of drug resistance has increased. The aim of this study was to evaluate levels of HIV-1 resistance among patients with HIV-1 and HIV-1/2 dual infections, treated with ART, at a large HIV clinic in Guinea-Bissau. FINDINGS: Patients were selected from the Bissau HIV cohort. All patients had HIV-1 or HIV-1/2 dual infection, a CD4 cell count performed before and 3–12 months after starting ART, and a corresponding available plasma sample. We measured viral load in patients with HIV-1 (n = 63) and HIV-1/2 dual (n = 16) infections a median of 184 days after starting ART (IQR: 126–235 days). In patients with virological failure (defined as viral load >1000 copies/ml) and with sufficient plasma available, we performed an HIV-1 genotypic resistance test. Thirty-six patients (46%) had virological failure. The CD4 cell count did not predict treatment failure. Of the 36 patients with virological failure, we performed a resistance test in 15 patients (42%), and nine patients (9/15; 60%) had resistance mutations. The most common mutation was K103N, which confers high-level resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI). No major mutations against protease inhibitors (PI) were found. CONCLUSIONS: Our results showed that patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau had a high rate of virological failure and rapid development of NNRTI resistance. It remains to be determined whether a more robust, PI-based treatment regimen might benefit this population more than NNRTIs. BioMed Central 2015-03-11 /pmc/articles/PMC4357169/ /pubmed/25889017 http://dx.doi.org/10.1186/s12985-015-0273-9 Text en © Jespersen et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Short Report
Jespersen, Sanne
Tolstrup, Martin
Hønge, Bo Langhoff
Medina, Candida
Té, David da Silva
Ellermann-Eriksen, Svend
Østergaard, Lars
Wejse, Christian
Laursen, Alex Lund
High level of HIV-1 drug resistance among patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau
title High level of HIV-1 drug resistance among patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau
title_full High level of HIV-1 drug resistance among patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau
title_fullStr High level of HIV-1 drug resistance among patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau
title_full_unstemmed High level of HIV-1 drug resistance among patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau
title_short High level of HIV-1 drug resistance among patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau
title_sort high level of hiv-1 drug resistance among patients with hiv-1 and hiv-1/2 dual infections in guinea-bissau
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357169/
https://www.ncbi.nlm.nih.gov/pubmed/25889017
http://dx.doi.org/10.1186/s12985-015-0273-9
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