Resistance in Patients Failing Integrase Strand Transfer Inhibitors: A Call to Replace Raltegravir With Dolutegravir in Third-Line Treatment in South Africa

Data on integrase resistance patterns in low- and middle-income countries (LMICs) is scarce. We assessed genotypic drug resistance in 43 patients with virological failure on integrase strand transfer inhibitors (INSTIs) containing regimens as part of the third-line treatment program in South Africa....

Descripción completa

Detalles Bibliográficos
Autores principales: Steegen, Kim, Van Zyl, Gert, Letsoalo, Esrom, Claassen, Mathilda, Hans, Lucia, Carmona, Sergio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Brief Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6786511/
https://www.ncbi.nlm.nih.gov/pubmed/31433056
http://dx.doi.org/10.1093/ofid/ofz377
_version_ 1783458074771587072
author Steegen, Kim
Van Zyl, Gert
Letsoalo, Esrom
Claassen, Mathilda
Hans, Lucia
Carmona, Sergio
author_facet Steegen, Kim
Van Zyl, Gert
Letsoalo, Esrom
Claassen, Mathilda
Hans, Lucia
Carmona, Sergio
author_sort Steegen, Kim
collection PubMed
description Data on integrase resistance patterns in low- and middle-income countries (LMICs) is scarce. We assessed genotypic drug resistance in 43 patients with virological failure on integrase strand transfer inhibitors (INSTIs) containing regimens as part of the third-line treatment program in South Africa. Of the raltegravir (RAL)-exposed patients 20 of 34 (59%) had ≥1 major INSTI mutation, including 2 (6%) with dolutegravir (DTG) cross-resistance. Dolutegravir resistance was detected in 1 of 4 DTG-exposed patients. Replacing RAL with DTG may reduce the risk of INSTI mutations. We recommend DTG drug resistance monitoring when DTG is introduced at a larger scale in LMICs.
format Online
Article
Text
id pubmed-6786511
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-67865112019-10-15 Resistance in Patients Failing Integrase Strand Transfer Inhibitors: A Call to Replace Raltegravir With Dolutegravir in Third-Line Treatment in South Africa Steegen, Kim Van Zyl, Gert Letsoalo, Esrom Claassen, Mathilda Hans, Lucia Carmona, Sergio Open Forum Infect Dis Brief Report Data on integrase resistance patterns in low- and middle-income countries (LMICs) is scarce. We assessed genotypic drug resistance in 43 patients with virological failure on integrase strand transfer inhibitors (INSTIs) containing regimens as part of the third-line treatment program in South Africa. Of the raltegravir (RAL)-exposed patients 20 of 34 (59%) had ≥1 major INSTI mutation, including 2 (6%) with dolutegravir (DTG) cross-resistance. Dolutegravir resistance was detected in 1 of 4 DTG-exposed patients. Replacing RAL with DTG may reduce the risk of INSTI mutations. We recommend DTG drug resistance monitoring when DTG is introduced at a larger scale in LMICs. Oxford University Press 2019-08-21 /pmc/articles/PMC6786511/ /pubmed/31433056 http://dx.doi.org/10.1093/ofid/ofz377 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Brief Report
Steegen, Kim
Van Zyl, Gert
Letsoalo, Esrom
Claassen, Mathilda
Hans, Lucia
Carmona, Sergio
Resistance in Patients Failing Integrase Strand Transfer Inhibitors: A Call to Replace Raltegravir With Dolutegravir in Third-Line Treatment in South Africa
title Resistance in Patients Failing Integrase Strand Transfer Inhibitors: A Call to Replace Raltegravir With Dolutegravir in Third-Line Treatment in South Africa
title_full Resistance in Patients Failing Integrase Strand Transfer Inhibitors: A Call to Replace Raltegravir With Dolutegravir in Third-Line Treatment in South Africa
title_fullStr Resistance in Patients Failing Integrase Strand Transfer Inhibitors: A Call to Replace Raltegravir With Dolutegravir in Third-Line Treatment in South Africa
title_full_unstemmed Resistance in Patients Failing Integrase Strand Transfer Inhibitors: A Call to Replace Raltegravir With Dolutegravir in Third-Line Treatment in South Africa
title_short Resistance in Patients Failing Integrase Strand Transfer Inhibitors: A Call to Replace Raltegravir With Dolutegravir in Third-Line Treatment in South Africa
title_sort resistance in patients failing integrase strand transfer inhibitors: a call to replace raltegravir with dolutegravir in third-line treatment in south africa
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6786511/
https://www.ncbi.nlm.nih.gov/pubmed/31433056
http://dx.doi.org/10.1093/ofid/ofz377
work_keys_str_mv AT steegenkim resistanceinpatientsfailingintegrasestrandtransferinhibitorsacalltoreplaceraltegravirwithdolutegravirinthirdlinetreatmentinsouthafrica
AT vanzylgert resistanceinpatientsfailingintegrasestrandtransferinhibitorsacalltoreplaceraltegravirwithdolutegravirinthirdlinetreatmentinsouthafrica
AT letsoaloesrom resistanceinpatientsfailingintegrasestrandtransferinhibitorsacalltoreplaceraltegravirwithdolutegravirinthirdlinetreatmentinsouthafrica
AT claassenmathilda resistanceinpatientsfailingintegrasestrandtransferinhibitorsacalltoreplaceraltegravirwithdolutegravirinthirdlinetreatmentinsouthafrica
AT hanslucia resistanceinpatientsfailingintegrasestrandtransferinhibitorsacalltoreplaceraltegravirwithdolutegravirinthirdlinetreatmentinsouthafrica
AT carmonasergio resistanceinpatientsfailingintegrasestrandtransferinhibitorsacalltoreplaceraltegravirwithdolutegravirinthirdlinetreatmentinsouthafrica

Ejemplares similares